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Circ Cardiovasc Interv. 2017 Dec;10(12). pii: e005860. doi: 10.1161/CIRCINTERVENTIONS.117.005860.

EROSION Study (Effective Anti-Thrombotic Therapy Without Stenting: Intravascular Optical Coherence Tomography-Based Management in Plaque Erosion): A 1-Year Follow-Up Report.

Author information

1
From the Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Key Laboratory of Myocardial Ischemia, China (L.X., H.J., L.M., S.H., C.W., Y.Z., L.L., M.X., H.L., J.H., S.Z., B.Y.); Cardiology Division (L.X., E.Y., T.S., K.B., I.-K.J.) and Biostatistics Center (H.L.), Massachusetts General Hospital, Harvard Medical School, Boston; and Division of Cardiology, Department of Internal Medicine, Kyung Hee University Hospital, Seoul, Republic of Korea (I.-K.J.).
2
From the Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Key Laboratory of Myocardial Ischemia, China (L.X., H.J., L.M., S.H., C.W., Y.Z., L.L., M.X., H.L., J.H., S.Z., B.Y.); Cardiology Division (L.X., E.Y., T.S., K.B., I.-K.J.) and Biostatistics Center (H.L.), Massachusetts General Hospital, Harvard Medical School, Boston; and Division of Cardiology, Department of Internal Medicine, Kyung Hee University Hospital, Seoul, Republic of Korea (I.-K.J.). yubodr@163.com ijang@mgh.harvard.edu.

Abstract

BACKGROUND:

The initial EROSION study (Effective Anti-Thrombotic Therapy Without Stenting: Intravascular Optical Coherence Tomography-Based Management in Plaque Erosion) demonstrated that patients with acute coronary syndrome caused by plaque erosion might be stabilized with aspirin and ticagrelor without stenting for ≤1 month. However, a long-term evaluation of outcomes is lacking. The aim of this study was to assess whether the initial benefit of noninterventional therapy for patients with acute coronary syndrome caused by plaque erosion is maintained for ≤1 year.

METHODS AND RESULTS:

Among 53 patients who completed clinical follow-up, 49 underwent repeat optical coherence tomography imaging at 1 year. Median residual thrombus volume decreased significantly from 1 month to 1 year (0.3 mm3 (0.0-2.0 mm3] versus 0.1 mm3 [0.0-2.0 mm3]; P=0.001). Almost half of the patients (46.9%) had no residual thrombus at 1 year. Minimal effective flow area remained unchanged (2.1 mm2 [1.5-3.8 mm2] versus 2.1 mm2 [1.6-4.0 mm2]; P=0.152). Among 53 patients, 49 (92.5%) remained free from major adverse cardiovascular event for ≤1 year: 3 (5.7%) patients required revascularization because of exertional angina and 1 (1.9%) patient had gastrointestinal bleeding.

CONCLUSIONS:

One-year follow-up optical coherence tomography demonstrated a further decrease in thrombus volume between 1-month and 1-year follow-up. A majority (92.5%) of patients with acute coronary syndrome caused by plaque erosion managed with aspirin and ticagrelor without stenting remained free of major adverse cardiovascular event for ≤1 year.

CLINICAL TRIAL REGISTRATION:

URL: https://www.clinicaltrials.gov. Unique identifier: NCT02041650.

KEYWORDS:

acute coronary syndrome; optical coherence tomography; thrombosis

[Indexed for MEDLINE]

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