Hoshino M, et al. - Among 510 patients with acute coronary syndrome who had optical coherence tomography for a culprit lesion, researchers examined if intact fibrous cap (IFC) has any clinical importance in relation to the presence or absence of lipid-rich plaque (LRP). The presence or absence of plaque rupture (PR) in the optical coherence tomography analysis allowed classification into the PR group and the IFC group, respectively. Based on the presence of LRP, further classification of the IFC group was done. They compared the incidence of major adverse cardiac events (MACEs), comprising cardiac mortality, myocardial infarction, and clinically driven remote revascularizations. According to findings, a lower risk of future MACEs may be predicted in acute coronary syndrome by excluding LRP underneath IFC culprit lesions.