Evidence map›Paper›PMID 33790317›Full record

ArticleScientific reports2021

Identification of the haemodynamic environment permissive for plaque erosion.

Michael McElroy, Yongcheol Kim, Giampaolo Niccoli, Rocco Vergallo, Alexander Langford-Smith, Filippo Crea, Frank Gijsen, Thomas Johnson, Amir Keshmiri, Stephen J White

Open access · goldAbstract read
In one paragraph

Article in Scientific reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed
6.9field-weighted citation impact, top 2% 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

22 citing papers in PubMed, 42 citations in OpenAlex.

  1. Article
  2. Review
  3. Vascular Toxicities of Cancer Therapies: 2025 Update.Arteriosclerosis, thrombosis, and vascular biology · 2026
    Review
  4. Pathogenesis of plaque erosion.Trends in cardiovascular medicine · 2026
    Review
  5. Review
  6. Article
  7. Risk Factors Favoring Plaque Erosion.Current atherosclerosis reports · 2024
    Review
  8. Article
  9. Article
  10. In the Beginning, Lipoproteins Cross the Endothelial Barrier.Journal of atherosclerosis and thrombosis · 2024
    Review
  11. Review
  12. Article
  13. Review
  14. Article
  15. Article
  16. Article
  17. Article
  18. Review
  19. Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 8 institutions in 4 countries.

Michael McElroyDepartment of Mechanical, Aerospace and Civil Engineering (MACE), The University of Manchester, Manchester, M13 9PL, UK.
Yongcheol KimDivision of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine and Cardiovascular Center, Yongin Severance Hospital, Yongin, Republic of Korea.
Giampaolo NiccoliDivision of Cardiology, Department of Medicine and Surgery, University of Parma, Parma, Italy.
Rocco VergalloFondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Alexander Langford-SmithDepartment of Life Sciences, Manchester Metropolitan University, Manchester, M1 5GD, UK.
Filippo CreaFondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Frank GijsenDepartment of Cardiology, Erasmus Medical Centre, Rotterdam, The Netherlands.
Thomas Johnson *Department of Cardiology, Bristol Heart Institute, University Hospitals Bristol and Weston NHS Foundation Trust, Upper Maudlin St., Bristol, BS2 8HW, UK.
Amir Keshmiri *Department of Mechanical, Aerospace and Civil Engineering (MACE), The University of Manchester, Manchester, M13 9PL, UK.
Stephen J White *Department of Life Sciences, Manchester Metropolitan University, Manchester, M1 5GD, UK. Stephen.white@mmu.ac.uk.
Manchester Metropolitan University · GBUniversity of Manchester · GBAgostino Gemelli University Polyclinic · ITErasmus University Rotterdam · NLIstituti di Ricovero e Cura a Carattere Scientifico · ITSeverance Hospital · KRUniversity Hospitals Bristol and Weston NHS Foundation TrustUniversity of Parma · IT

Funding

British Heart Foundation CH95/001British Heart Foundation FS/12/77/29887British Heart Foundation PG/11/44/28972British Heart Foundation PG/17/67/33218
6 · The paper itself

Abstract

Endothelial erosion of atherosclerotic plaques is the underlying cause of approximately 30% of acute coronary syndromes (ACS). As the vascular endothelium is profoundly affected by the haemodynamic environment to which it is exposed, we employed computational fluid dynamic (CFD) analysis of the luminal geometry from 17 patients with optical coherence tomography (OCT)-defined plaque erosion, to determine the flow environment permissive for plaque erosion. Our results demonstrate that 15 of the 17 cases analysed occurred on stenotic plaques with median 31% diameter stenosis (interquartile range 28-52%), where all but one of the adherent thrombi located proximal to, or within the region of maximum stenosis. Consequently, all flow metrics related to elevated flow were significantly increased (time averaged wall shear stress, maximum wall shear stress, time averaged wall shear stress gradient) with a reduction in relative residence time, compared to a non-diseased reference segment. We also identified two cases that did not exhibit an elevation of flow, but occurred in a region exposed to elevated oscillatory flow. Our study demonstrates that the majority of OCT-defined erosions occur where the endothelium is exposed to elevated flow, a haemodynamic environment known to evoke a distinctive phenotypic response in endothelial cells.

Indexed as

HemodynamicsModels, CardiovascularStress, MechanicalAcute Coronary SyndromeAdultAgedFemaleHumansMaleMiddle AgedPlaque, AtheroscleroticTomography, Optical Coherence

Identifiers

PMID33790317
PMCPMC8012657
OpenAlexW3145752448

What OpenQuestion holds

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LicenceCC BY
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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.