{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:51:06Z","timestamp":1753876266946,"version":"3.41.2"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2021,5,31]],"date-time":"2021-05-31T00:00:00Z","timestamp":1622419200000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,5,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Intracoronary imaging techniques have allowed characterizing atherosclerotic plaques morphologically in patients with the acute coronary syndrome (ACS). Although the main feature described is plaque rupture, the use of optical coherence tomography has made it possible to objectify that the eroded plaque is not uncommon in this setting.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>We presented a case of a 45-year-old man with active smoking and cocaine user, admitted to the emergency department for chest pain. The electrocardiogram showed ST-segment elevation myocardial infarction (STEMI) in the inferior leads. Emergent coronary angiography was performed, showing thrombotic occlusion of mid-distal right coronary artery. After successful thromboaspiration, no areas of significant angiographic stenosis were observed. Optical coherence tomography imaging at the occlusion site revealed an eroded plaque and a remaining small thrombusburden. Conservative management without stent implantation was decided. Treatments consisted of an acute phase glycoprotein IIb\/IIIa inhibitor and subsequently dual antiplatelet therapy with Aspirin (ASA) and Ticagrelor 90\u2009mg b.i.d. for 12\u2009months. The patient remains asymptomatic and uneventful at 9-month follow-up.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Young age, history of active smoking, and cocaine use are common clinical features in patients with ACS due to an eroded plaque. These patients frequently display a STEMI with the involvement of a single coronary vessel. Optical coherence tomography imaging aids to a precise diagnosis and to define a proper treatment.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytab128","type":"journal-article","created":{"date-parts":[[2021,5,31]],"date-time":"2021-05-31T08:10:07Z","timestamp":1622448607000},"source":"Crossref","is-referenced-by-count":0,"title":["A case report of cocaine abuse, acute coronary syndrome, and eroded plaque: stent or not stent?"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2887-1206","authenticated-orcid":false,"given":"Isabel","family":"Mu\u00f1oz Pousa","sequence":"first","affiliation":[{"name":"Department of Cardiology, Hospital Universitario \u00c1lvaro Cunqueiro , Estrada Clara Campoamor, 341, 36212 Vigo, Pontevedra, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6555-5697","authenticated-orcid":false,"given":"Ubaldo","family":"Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Universitario \u00c1lvaro Cunqueiro , Estrada Clara Campoamor, 341, 36212 Vigo, Pontevedra, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5271-1993","authenticated-orcid":false,"given":"Victor A","family":"Jim\u00e9nez D\u00edaz","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Universitario \u00c1lvaro Cunqueiro , Estrada Clara Campoamor, 341, 36212 Vigo, Pontevedra, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,5,31]]},"reference":[{"key":"2022081611373016300_ytab128-B1","doi-asserted-by":"crossref","first-page":"1959","DOI":"10.1161\/CIRCRESAHA.114.302782","article-title":"Global perspective on acute coronary syndrome: a burden on the young and poor","volume":"114","author":"Vedanthan","year":"2014","journal-title":"Circ Res"},{"key":"2022081611373016300_ytab128-B2","doi-asserted-by":"crossref","first-page":"1748","DOI":"10.1016\/j.jacc.2013.05.071","article-title":"In vivo diagnosis of plaque erosion and calcified nodule in patients with acute coronary syndrome by intravascular optical coherence tomography","volume":"62","author":"Jia","year":"2013","journal-title":"J Am Coll Cardiol"},{"key":"2022081611373016300_ytab128-B3","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1093\/eurheartj\/ehs411","article-title":"Update on acute coronary syndromes: the pathologists' 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tomography study","volume":"39","author":"Dai","year":"2018","journal-title":"Eur Heart J"},{"key":"2022081611373016300_ytab128-B7","doi-asserted-by":"crossref","first-page":"1897","DOI":"10.1161\/CIRCULATIONAHA.107.188950","article-title":"Management of cocaine-associated chest pain and myocardial infarction: a scientific statement from the American Heart Association Acute Cardiac Care Committee of the Council on Clinical Cardiology","volume":"117","author":"McCord","year":"2008","journal-title":"Circulation"},{"key":"2022081611373016300_ytab128-B8","first-page":"792","article-title":"Effective anti-thrombotic therapy without stenting: intravascular optical coherence tomography-based management in plaque erosion (the EROSION study)","volume":"38","author":"Jia","year":"2017","journal-title":"Eur Heart J"},{"key":"2022081611373016300_ytab128-B9","doi-asserted-by":"crossref","first-page":"e004730","DOI":"10.1161\/JAHA.116.004730","article-title":"Management and outcome of patients with acute coronary syndrome caused by plaque rupture versus plaque erosion: an intravascular optical coherence tomography study","volume":"6","author":"Hu","year":"2017","journal-title":"JAHA"},{"issue":"12","key":"2022081611373016300_ytab128-B10","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCINTERVENTIONS.117.006143","article-title":"Antithrombotic therapy alone for plaque erosion: ready for a paradigm shift in acute coronary syndromes?","volume":"10","author":"Alfonso","year":"2017","journal-title":"Circ Cardiovasc Interv"},{"key":"2022081611373016300_ytab128-B11","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1097\/MCA.0000000000000614","article-title":"Thrombus resolution with tirofiban in the conservative management of patients presenting with plaque erosion","volume":"29","author":"Sugiyama","year":"2018","journal-title":"Coron Artery Dis"}],"container-title":["European Heart Journal - Case 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