Amano H, et al. - In this analysis of 84 lesions in 76 patients undergoing optical coherence tomography (OCT) prior to percutaneous coronary intervention, researchers assessed clinical and procedure traits, plaque traits, slow flow after stent implantation, and clinical outcomes with irregular protrusion using OCT. In 56% (47/84) of cases, lesions with irregular protrusion were seen. Irregular protrusion on OCT vs lesions without irregular protrusion was associated with significantly higher low-density lipoprotein cholesterol (LDL-C) levels (108 ± 31 mg/dl vs 95 ± 25 mg/dl); a inclination toward reduced statin use [44% (19/43) vs 67% (22/33)]; significantly greater reference vessel diameter (3.12 ± 0.53 mm vs 2.74 ± 0.63 mm); a higher frequency of slow flow after stent implantation [38% (18/47) vs 11% (4/37)]; higher incidence of thin-cap fibroatheromas [TCFAs; 49% (23/47) vs 5% (2/37)]; plaque rupture [40% (19/47) vs 16% (6/37)]; and a higher incidence of 1-year adverse clinical outcomes (death, acute myocardial infarction, acute coronary syndrome, or target lesion revascularization) [12% (5/43) vs 0% (0/33)].