Friday, April 9, 2010

The MGH leads international study to identify vulnerable coronary plaques

OCT PIONEER: Jang at the March 13 OCT Registry Symposium

Optical coherence tomography (OCT) is an intravascular imaging technology that offers the promise of revealing the microscopic characteristics of a vulnerable coronary plaque. Using near-infrared light, OCT creates extremely high-resolution images from within an artery. The images have a resolution at least 20 times better than standard imaging technologies, such as computed tomography.

MGH Heart Center researchers, together with a coalition of 20 international sites, will create the world's largest registry of patients who have had OCT of the coronary arteries. Researchers hope the data will help determine the ability of OCT to identify vulnerable plaques in patients as well as its benefits as a follow-up procedure to stent placement.

When a vulnerable plaque in a coronary artery ruptures, the result can be catastrophic, blocking blood flow to the heart muscle and causing a heart attack. Cardiologists estimate that vulnerable plaques cause two-thirds to three-quarters of all fatal heart attacks. Standard imaging technologies are not able to identify the microscopic characteristics of these at-risk plaques.

The international research team -- led by MGH interventional cardiologist Ik-Kyung Jang, MD, PhD, a pioneer in the field of cardiac OCT -- will collect data from 3,000 patients who had cardiac OCT during a catheterization procedure and will follow them for five years with the goal of determining the effectiveness of the technique in identifying at-risk patients.

In a clinical study in 2002, Jang was the first physician to use OCT technology in a human heart, and he has led several studies of the technology over the years. Use of cardiac OCT has grown exponentially with more than 10,000 cases performed worldwide last year.

"The MGH OCT Registry is the first international effort to share information about OCT use in cardiac care," says Jang. "This collaboration will bring together a wealth of information and help us facilitate scientific advancement in the field."

The registry was launched during the first MGH OCT Registry Symposium on March 13. The study's international sites in Japan, China, Korea and Australia will begin enrolling patients in June. Enrollment in the United States will begin pending clearance of the technology by the U.S. Food and Drug Administration.

"The development of OCT and its rapid adoption are enabling clinicians to capture in vivo what was previously seen only through a pathologist's microscope," says Jang. "Of course, the long-term goal is to identify plaques and prevent sudden cardiac death and heart attacks."

For more information, e-mail Iris A. McNulty, BSN, RN, of the Cardiology Division, at

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