Evidence map›Paper›PMID 32832991›Full record

ArticleCardiovascular research2021

High spatial endothelial shear stress gradient independently predicts site of acute coronary plaque rupture and erosion.

Vikas Thondapu, Chris Mamon, Eric K W Poon, Osamu Kurihara, Hyung Oh Kim, Michele Russo, Makoto Araki, Hiroki Shinohara, Erika Yamamoto, Jouke Dijkstra and 5 more

Abstract read
PubMed Publisher
In one paragraph

Article in Cardiovascular research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers.

0numbers the graph read from it
0cells of the map it votes in
45citing papers in PubMed
9.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

45 citing papers in PubMed, 84 citations in OpenAlex.

  1. Article
  2. Pathogenesis of plaque erosion.Trends in cardiovascular medicine · 2026
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors at 4 institutions in 5 countries.

Vikas ThondapuCardiology Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA.ORCID 0000-0002-3291-2632
Chris MamonDepartment of Mechanical Engineering, School of Engineering, University of Melbourne, Melbourne, VIC 3010, Australia.
Eric K W PoonDepartment of Mechanical Engineering, School of Engineering, University of Melbourne, Melbourne, VIC 3010, Australia.
Osamu KuriharaCardiology Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA.
Hyung Oh KimCardiology Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA.ORCID 0000-0003-2157-441X
Michele RussoCardiology Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA.
Makoto ArakiCardiology Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA.
Hiroki ShinoharaCardiology Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA.
Erika YamamotoDepartment of Cardiovascular Medicine, Kyoto University, Kyoto 606-8501, Japan.
Jouke DijkstraDivision of Image Processing, Department of Radiology, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.ORCID 0000-0002-8666-3731
Mark TaceyDepartment of Medicine and Radiology, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC 3010, Australia.
Hang LeeBiostatistics Center, Massachusetts General Hospital, Harvard Medical School, 50 Standiford St, Suite 560, Boston, MA 02114, USA.
Andrew OoiDepartment of Mechanical Engineering, School of Engineering, University of Melbourne, Melbourne, VIC 3010, Australia.ORCID 0000-0003-1126-7838
Peter BarlisDepartment of Medicine and Radiology, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC 3010, Australia.ORCID 0000-0003-2447-6815
Ik-Kyung JangCardiology Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA.
Harvard University · USThe University of Melbourne · AUKyoto University · JPLeiden University · NL

Funding

Infrastructure, Equipment and Facilities LE190100021Kathryn ParkNational Computational InfrastructureSustaining and Strengthening Merit-Based AccessThe University of Melbourne
6 · The paper itself

Abstract

aimsTo investigate local haemodynamics in the setting of acute coronary plaque rupture and erosion. METHODS AND

resultsIntracoronary optical coherence tomography performed in 37 patients with acute coronary syndromes caused by plaque rupture (n = 19) or plaque erosion (n = 18) was used for three-dimensional reconstruction and computational fluid dynamics simulation. Endothelial shear stress (ESS), spatial ESS gradient (ESSG), and oscillatory shear index (OSI) were compared between plaque rupture and erosion through mixed-effects logistic regression. Lipid, calcium, macrophages, layered plaque, and cholesterol crystals were also analysed. By multivariable analysis, only high ESSG [odds ratio (OR) 5.29, 95% confidence interval (CI) 2.57-10.89, P < 0.001], lipid (OR 12.98, 95% CI 6.57-25.67, P < 0.001), and layered plaque (OR 3.17, 95% CI 1.82-5.50, P < 0.001) were independently associated with plaque rupture. High ESSG (OR 13.28, 95% CI 6.88-25.64, P < 0.001), ESS (OR 2.70, 95% CI 1.34-5.42, P = 0.005), and OSI (OR 2.18, 95% CI 1.33-3.54, P = 0.002) independently associated with plaque erosion. ESSG was higher at rupture sites than erosion sites [median (interquartile range): 5.78 (2.47-21.15) vs. 2.62 (1.44-6.18) Pa/mm, P = 0.009], OSI was higher at erosion sites than rupture sites [1.04 × 10-2 (2.3 × 10-3-4.74 × 10-2) vs. 1.29 × 10-3 (9.39 × 10-5-3.0 × 10-2), P < 0.001], but ESS was similar (P = 0.29).

conclusionsHigh ESSG is independently associated with plaque rupture while high ESSG, ESS, and OSI associate with plaque erosion. While ESSG is higher at rupture sites than erosion sites, OSI is higher at erosion sites and ESS was similar. These results suggest that ESSG and OSI may play critical roles in acute plaque rupture and erosion, respectively.

Indexed as

Coronary CirculationHemodynamicsPlaque, AtheroscleroticTomography, Optical CoherenceAcute Coronary SyndromeAgedCoronary AngiographyCoronary Artery DiseaseCoronary VesselsEndothelium, VascularFemaleHumansHydrodynamicsMaleMiddle AgedModels, CardiovascularComputational fluid dynamicsOptical coherence tomographyPlaque erosionPlaque ruptureShear stress gradient

Identifiers

PMID32832991
OpenAlexW3081049904

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.