Study Population

This is a prospective observational study conducted at Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine. Our study complied with the declaration of Helsinki and was approved by the hospital ethnics review board (No. 2016-256-T191). Informed consent was obtained from all the participants. A total number of 186 consecutive ACS patients were evaluated for enrollment in this study during the period from September 2016 to December 2020. All the patients received elective coronary angiography and OCT within 72 hours after admission. A total number of 82 ACS patients with only intermediate coronary lesions were finally enrolled and evaluated. One hundred and four ACS patients were excluded from the study because they also had severe stenosis (>70%) in other main coronary arteries. ACS was clinically diagnosed according to the elevated cardiac biomarkers, abnormal electrocardiogram indicating myocardial ischemia, clinical symptoms of angina pectoris or cardiac wall motion abnormalities by echocardiography. ACS included ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI), and unstable angina pectoris (UA). Patients with severe valvular heart disease, severe heart failure, infectious disease, autoimmune diseases, serious lung diseases, sever liver and kidney disease, malignant tumor, hemorrhage, and hematologic disorders were excluded from the study.

All patients were routinely treated with anti-platelet drugs, statins, β-blocker or angiotensin converting enzyme inhibitor or angiotensin II receptor blocker. Demographic information, clinical data and laboratory findings were collected. All the patients were followed up every 3 months for a median of 35.0 months [18.0, 45.5]. Major adverse cardiac events (MACE) were recorded during the period of follow-up. MACE was defined as the composite of all cause death, cardiac death, MI, coronary revascularization and stroke.