Yamamoto E, Yonetsu T, Kakuta T, et al. - In this retrospective registry study, researchers examined patients with acute coronary syndromes (ACS) who had optical coherence tomography imaging done, to determine predictors, clinical or laboratory, of plaque erosion so that a diagnosis of erosion could be made without additional invasive procedures. The patients were recruited from 11 institutions in 6 countries. They divided patients into plaque rupture, plaque erosion, or calcified plaque. Age < 68 years, anterior ischemia, no diabetes mellitus, hemoglobin > 15.0 g/dL, and normal renal function were identified as 5 independent parameters that were related to plaque erosion, in multivariable logistic regression models. A rise in the likelihood of plaque erosion to 73.1% was noted when all 5 parameters were present in a patient with non–ST-segment elevation-ACS. To detect the subset of ACS patients with plaque erosion as well as to guide them to conservative management without invasive procedures, the possible utility of these parameters is suggested. Verification of these findings in large scale prospective clinical investigations is required.