Abstract
Background: Vulnerable plaque is the predominant pathomechanism of acute coronary syndrome. OCT, with 10-20 µm axial resolution, is the gold standard for in vivo identification of high-risk plaque morphologies. Objectives: (1) Determine the prevalence and characteristics of vulnerable plaque subtypes (TCFA, lipid pool, thrombus, plaque rupture, erosion) by OCT; (2) Investigate associations with clinical features. Methods: Cross-sectional descriptive study on 246 patients with documented vulnerable plaque data who underwent OCT-guided PCI at Kien Giang General Hospital. Statistics: frequency description, Chi-square/Fisher, multivariable logistic regression. Results: Overall vulnerable plaque prevalence: 67.9% (167/246); lipid pool 64.3%; TCFA 37.4%; plaque rupture 28.8%; white clot 8.3%; erosion 7.2%. Multivariable analysis: ACS was the strongest predictor (aOR=9.21; 95% CI: 1.82-46.55; p=0.009); LDL-C was an independent lipid predictor (aOR=2.88/mmol/L; p=0.002). Model AUC=0.81. Conclusion: OCT identified a high prevalence of vulnerable plaque in PCI patients. ACS and elevated LDL-C are independent determinants of plaque vulnerability.
