Role of Optical Coherence Tomography in Diagnosis and Treatment of Patients with Acute Coronary Syndrome

Acute coronary syndrome (ACS) is the main cause of death worldwide and the leading cause of disease burden in high-income countries. ACS refers to a constellation of clinical symptoms that are compatible with acute myocardial ischemia. It describes a spectrum of clinical manifestations that result from a common pathophysiological process. The most common cause of ACS are rupture of an atherosclerotic lesion containing a large necrotic core and a thin fibrous cap followed by acute luminal thrombosis. It was thought that a high-resolution imaging modality would be ideal to detect high-risk plaques before their disruption and the formation of an occlusive thrombus. Optical coherence tomography has proven to be an invaluable tool in early detection of high-risk plaques and particularly in the understanding of ACS. This review focuses on the current evidence for the role of optical coherence tomography in the diagnosis and treatment of patients with ACS