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Meng PN, Nong JC, Xu Y, You W, Xu T, Wu XQ, Wu ZM, Tao BL, Guo YJ, Yin DL, Jia HB, Yang S, Ye F. Morphologies and composition changes in nonculprit subclinical atherosclerosis in diabetic versus nondiabetic patients with acute coronary syndrome who underwent long-term statin therapy. Sci Rep 2023; 13:5338. [PMID: 37005448 PMCID: PMC10067820 DOI: 10.1038/s41598-023-32638-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 03/30/2023] [Indexed: 04/04/2023] Open
Abstract
Although patients are undergoing similar lipid-lowering therapy (LLT) with statins, the outcomes of coronary plaque in diabetic mellitus (DM) and non-DM patients are different. Clinical data of 239 patients in this observational study with acute coronary syndrome was from our previous randomized trial were analyzed at 3 years, and 114 of them underwent OCT detection at baseline and the 1-year follow-up were re-anlayzed by a novel artificial intelligence imaging software for nonculprit subclinical atherosclerosis (nCSA). Normalized total atheroma volume changes (ΔTAVn) of nCSA were the primary endpoint. Plaque progression (PP) was defined as any increase in ΔTAVn. DM patients showed more PP in nCSA (ΔTAVn; 7.41 (- 2.82, 11.85) mm3 vs. - 1.12 (- 10.67, 9.15) mm3, p = 0.009) with similar reduction of low-density lipoprotein cholesterol (LDL-C) from baseline to 1-year. The main reason is that the lipid component in nCSA increases in DM patients and non-significantly decreases in non-DM patients, which leads to a significantly higher lipid TAVn (24.26 (15.05, 40.12) mm3 vs. 16.03 (6.98, 26.54) mm3, p = 0.004) in the DM group than in the non-DM group at the 1-year follow-up. DM was an independent predictor of PP in multivariate logistic regression analysis (OR = 2.731, 95% CI 1.160-6.428, p = 0.021). Major adverse cardiac events (MACEs) related to nCSA at 3 years were higher in the DM group than in the non-DM group (9.5% vs. 1.7%, p = 0.027). Despite a comparable reduction in LDL-C levels after LLT, more PP with an increase in the lipid component of nCSA and a higher incidence of MACEs at the 3-year follow-up was observed in DM patients.Trial registration: ClinicalTrials.gov. identifier: NCT02140801.
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Affiliation(s)
- Pei-Na Meng
- Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing, 210006, China
| | - Jia-Cong Nong
- Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing, 210006, China
| | - Yi Xu
- Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing, 210006, China
| | - Wei You
- Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing, 210006, China
| | - Tian Xu
- Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing, 210006, China
| | - Xiang-Qi Wu
- Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing, 210006, China
| | - Zhi-Ming Wu
- Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing, 210006, China
| | - Bi-Lin Tao
- Department of Epidemiology and Biostatistics, Center for Global Health, School of Public Health, Nanjing Medical University, 101 Longmian Ave., Nanjing, 211166, China
| | - Ya-Jie Guo
- Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing, 210006, China
| | - De-Lu Yin
- Department of Cardiology, The First Hospital of Lianyungang, Xuzhou Medical University, No. 6 East Zhenhua Road, Haizhou District, Lianyungang, 222061, China
| | - Hai-Bo Jia
- Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing, 210006, China.
| | - Song Yang
- Department of Cardiology, The People's Hospital of Yixing City, 75 Tongzhenguan Road, Yixing, 214200, China.
| | - Fei Ye
- Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing, 210006, China.
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Allen KB, Alexander JE, Liberman JN, Gabriel S. Implications of Payment for Acute Myocardial Infarctions as a 90-Day Bundled Single Episode of Care: A Cost of Illness Analysis. PHARMACOECONOMICS - OPEN 2022; 6:799-809. [PMID: 35226305 PMCID: PMC9596673 DOI: 10.1007/s41669-022-00328-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/25/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES Evaluate the cost of illness associated with the 90-day period following acute myocardial infarction (AMI) and the implication of care pathway (percutaneous coronary intervention [PCI] vs medical management [MM]), in order to assess the potential financial risk incurred by providers for AMI as an episode of care. PERSPECTIVE Reimbursement payment systems for acute care episodes are shifting from 30-day to 90-day bundled payment models. Since follow-up care and readmissions beyond the early days/weeks post-AMI are common, financial risk may be transferred to providers. SETTING AMI hospitalization Centers for Medicare & Medicaid Services (CMS) standard analytical files between 10/1/2015 and 9/30/2016 were reviewed. METHODS Included patients were Medicare beneficiaries with a primary diagnosis of AMI subsequently treated with either PCI or MM. Payments were standardized to remove geographic variation and separated into reimbursements for services during the hospitalization and from discharge to 90 days post-discharge. Results were stratified by Medicare Severity Diagnosis Related Groups (MS-DRGs) individually and grouped between patients treated with MM and PCI. Risk-adjusted likelihood of utilization of post-acute nursing care and all-cause readmission was assessed by logistic regression. RESULTS A total of 96,546 patients were included in the analysis. The highest total mean payment (US$32,714) was for MS-DRG 248 (PCI with non-drug-eluting stent with major complication or comorbidity). Total payments were similar between MM and PCI patients, but MM patients incurred the majority of costs in the post-acute period after discharge, with the converse true for PCI patients. MM without catheterization was associated with a twofold increase in risk of requiring post-acute nursing care and 90-day readmission versus PCI (odds ratio [95% confidence interval]: 2.01 [1.92-2.11] and 2.17 [2.08-2.27]). Smaller hospital size, diabetes, peripheral arterial disease, prior AMI, and multivessel disease were predictors of higher healthcare utilization. CONCLUSIONS MS-DRGs associated with the lowest reimbursements (and presumably, lowest costs of inpatient care) incur the highest post-discharge expenditures. As the CMS Bundled Payment for Care Improvement and similar programs are implemented, there will be a need to account for heterogeneous post-discharge care costs. Video abstract (MP4 274659 KB).
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Affiliation(s)
- Keith B Allen
- St. Luke's Mid America Heart Institute, Kansas City, MO, USA
| | | | | | - Susan Gabriel
- CSL Behring, 1020 First Avenue, P.O. Box 61501, King of Prussia, PA, 19406, USA.
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Si D, Du B, Zhao Y, Li X, Wang X, Liu K, He Y, Yang P. Combined intracoronary assessment and treatment of a patient with coronary plaque rapid progression prior to acute myocardial infarction: A case report. Medicine (Baltimore) 2019; 98:e15621. [PMID: 31083259 PMCID: PMC6531148 DOI: 10.1097/md.0000000000015621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
RATIONAL Plaque rapid progression prior to acute myocardial infarction is not a common phenomenon, and its mechanism remains unknown. Intracoronary imaging may help to assess the plaque characteristics and progression. PATIENT CONCERN A 37-year-old male patient suffered an acute myocardial infarction (AMI) 1 month after the diagnosis of a mildly stenosed coronary artery. Intracoronary imaging was done to seek the underlying causes and guide further treatment. DIAGNOSIS Two coronary angiograms in 1 month showed plaque rapid progressing prior to the AMI. Intracoronary optical coherence tomography (OCT) post-AMI showed plaque erosion and heavy burden of thrombus. INTERVENTION The patient was advised to defer stent deployment. The patient was then given intensified antithrombotic therapy. Three weeks later, OCT imaging revealed sufficient lumen area and the intact endothelium without remaining thrombus. Fractional flow reverse (FFR) showed no functional ischemia. Dual-antiplatelet therapy without stenting was recommended for 12 months. OUTCOMES The 6-month follow-up showed good recovery and normal cardiac function. LESSONS First, for patients with mild coronary stenosis and typical angina symptoms, further intracoronary assessment should be performed. Second, OCT can not only help to determine the plaque characteristics but can also help to develop patient-tailored strategies for AMI patients.
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Affiliation(s)
- Daoyuan Si
- Jilin Provincial Engineering Laboratory for Endothelial Function and Genetic Diagnosis of Cardiovascular Disease, Department of Cardiology, China-Japan Union Hospital of Jilin University
| | - Beibei Du
- Jilin Provincial Engineering Laboratory for Endothelial Function and Genetic Diagnosis of Cardiovascular Disease, Department of Cardiology, China-Japan Union Hospital of Jilin University
| | - Yanan Zhao
- Jilin Provincial Engineering Laboratory for Endothelial Function and Genetic Diagnosis of Cardiovascular Disease, Department of Cardiology, China-Japan Union Hospital of Jilin University
| | - Xiangdong Li
- Jilin Provincial Engineering Laboratory for Endothelial Function and Genetic Diagnosis of Cardiovascular Disease, Department of Cardiology, China-Japan Union Hospital of Jilin University
| | - Xingtong Wang
- Department of Oncology and Hematology, Cancer Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Kun Liu
- Jilin Provincial Engineering Laboratory for Endothelial Function and Genetic Diagnosis of Cardiovascular Disease, Department of Cardiology, China-Japan Union Hospital of Jilin University
| | - Yuquan He
- Jilin Provincial Engineering Laboratory for Endothelial Function and Genetic Diagnosis of Cardiovascular Disease, Department of Cardiology, China-Japan Union Hospital of Jilin University
| | - Ping Yang
- Jilin Provincial Engineering Laboratory for Endothelial Function and Genetic Diagnosis of Cardiovascular Disease, Department of Cardiology, China-Japan Union Hospital of Jilin University
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Rodríguez-Granillo GA, Carrascosa P, Deviggiano A, Capunay C, de Zan MC, Goldsmit A. Extensión y distribución espacial de la carga ateroesclerótica mediante imágenes monocromáticas virtuales derivadas de tomografía computarizada de doble energía. Rev Esp Cardiol 2016. [DOI: 10.1016/j.recesp.2016.02.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Rodríguez-Granillo GA, Carrascosa P, Deviggiano A, Capunay C, de Zan MC, Goldsmit A. Extension and Spatial Distribution of Atherosclerotic Burden Using Virtual Monochromatic Imaging Derived From Dual-energy Computed Tomography. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2016; 69:915-922. [PMID: 27324434 DOI: 10.1016/j.rec.2016.02.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 02/25/2016] [Indexed: 06/06/2023]
Abstract
INTRODUCTION AND OBJECTIVES We explored the differences between atherosclerotic burden with invasive coronary angiography and virtual monochromatic imaging derived from dual-energy computed tomography coronary angiography. METHODS Eighty consecutive patients referred for invasive coronary angiography underwent dual-energy computed tomography coronary angiography and were categorized according to the atherosclerotic burden extent using the modified Duke prognostic coronary artery disease index, coronary artery disease extension score, segment involvement score, and the segment stenosis score. RESULTS The mean segment involvement score (8.2 ± 3.9 vs 6.0 ± 3.7; P < .0001), modified Duke index (4.33 ± 1.6 vs 4.0 ± 1.7; P = .003), coronary artery disease extension score (4.84 ± 1.8 vs 4.43 ± 2.1; P = .005), and the median segment stenosis score (13.5 [9.0-18.0] vs 9.5 [5.0-15.0]; P < .0001) were significantly higher on dual-energy computed tomography compared with invasive angiography. Dual-energy computed tomography showed a significantly higher number of patients with any left main coronary artery lesion (46 [58%] vs 18 [23%]; P < .0001) and with severe proximal lesions (0.28 ± 0.03 vs 0.26 ± 0.03; P < .0001) than invasive angiography. Levels of coronary artery calcification below and above the median showed a sensitivity, specificity, positive predictive value, and negative predictive value of 100% and 97%; 86% and 50%; 93% and 95%; 100% and 67% for the identification of ≥ 50% stenosis. CONCLUSIONS Dual-energy computed tomography coronary angiography identified a significantly larger atherosclerotic burden compared with invasive coronary angiography, particularly involving the proximal segments.
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Affiliation(s)
| | - Patricia Carrascosa
- Departamento de Imágenes Cardiovasculares, Diagnóstico Maipú, Buenos Aires, Argentina
| | - Alejandro Deviggiano
- Departamento de Imágenes Cardiovasculares, Diagnóstico Maipú, Buenos Aires, Argentina
| | - Carlos Capunay
- Departamento de Imágenes Cardiovasculares, Diagnóstico Maipú, Buenos Aires, Argentina
| | - Macarena C de Zan
- Departamento de Imágenes Cardiovasculares, Diagnóstico Maipú, Buenos Aires, Argentina
| | - Alejandro Goldsmit
- Departamento de Cardiología Intervencionista, Sanatorio Güemes, Buenos Aires, Argentina
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Hassan A, ElGuindy A, Antoniucci D. Culprit lesion-only versus complete revascularization in patients with STEMI: Lessons learned from PRAMI, CvLPRIT, and DANAMI-3 PRIMULTI. Glob Cardiol Sci Pract 2015; 2015:60. [PMID: 26925405 PMCID: PMC4754560 DOI: 10.5339/gcsp.2015.60] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Accepted: 09/29/2015] [Indexed: 11/08/2022] Open
Affiliation(s)
- Ahmed Hassan
- Aswan Heart Centre, Aswan, Egypt
- Department of Cardiology, Cairo University, Cairo, Egypt
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Agarwal SK. Culprit Artery Only or Multivessel Primary PCI: The Debate Continues. J Am Coll Cardiol 2015; 66:1744-5. [PMID: 26449149 DOI: 10.1016/j.jacc.2015.06.1351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 06/01/2015] [Indexed: 11/25/2022]
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Abstract
PURPOSE OF REVIEW New therapeutic strategies are needed for the rapid stabilization of acute coronary syndrome (ACS) patients by treating nonculprit lesions. Reconstituted HDL (rHDL), which is apoA-I combined with phospholipids, is currently being tested in clinical trials for this purpose and is the subject of this review. RECENT FINDINGS At least four different formulations (SRC-rHDL, CSL-111, CSL-112 and ETC-216) have been tested in clinical trials. The various rHDL preparations have been shown to be effective in the rapid mobilization of excess cholesterol from cells and in regressing atherosclerotic plaques in animal models. Two of the rHDL agents, namely ETC-216 and CSL-111, have been shown to be effective after only a few treatments in reducing plaque volume in ACS patients, as assessed by intravascular ultrasound, but no clinical trials assessing clinical endpoints have yet been completed. SUMMARY rHDL is a promising new potential therapy for ACS patients, but much work remains to be done, and there are many unresolved questions. Progress in developing rHDL into a therapy will depend on improving our understanding of their mechanism of action, determining the optimum formulation and delivery and how to monitor rHDL therapy.
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Affiliation(s)
- Brian R Krause
- aAlphaCore Pharma, Ann Arbor, Michigan bLipoprotein Metabolism Section, Cardiopulmonary Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
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A Review of JACC Journal Articles on the Topic of Interventional Cardiology: 2011–2012. J Am Coll Cardiol 2013. [DOI: 10.1016/j.jacc.2013.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Epstein SE, Waksman R, Pichard AD, Kent KM, Panza JA. Percutaneous Coronary Intervention Versus Medical Therapy in Stable Coronary Artery Disease. JACC Cardiovasc Interv 2013; 6:993-8. [DOI: 10.1016/j.jcin.2013.07.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 07/21/2013] [Indexed: 12/26/2022]
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Kinoshita T, Asai T, Suzuki T. Preoperative SYNTAX score and graft patency after off-pump coronary bypass surgery†. Eur J Cardiothorac Surg 2013; 44:e25-31. [DOI: 10.1093/ejcts/ezt156] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Marso SP, Mercado N, Maehara A, Weisz G, Mintz GS, McPherson J, Schiele F, Dudek D, Fahy M, Xu K, Lansky A, Templin B, Zhang Z, de Bruyne B, Serruys PW, Stone GW. Plaque composition and clinical outcomes in acute coronary syndrome patients with metabolic syndrome or diabetes. JACC Cardiovasc Imaging 2012; 5:S42-52. [PMID: 22421230 DOI: 10.1016/j.jcmg.2012.01.008] [Citation(s) in RCA: 99] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2011] [Revised: 01/19/2012] [Accepted: 01/26/2012] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The goal of this study was to characterize the extent and composition of coronary atherosclerosis in patients with diabetes mellitus or the metabolic syndrome (Met Syn) presenting with acute coronary syndromes (ACS). BACKGROUND Diabetes and Met Syn patients have increased rates of major adverse cardiac events (MACE), yet a systematic description of nonculprit lesions for these high-risk groups is incomplete. METHODS In the PROSPECT (Providing Regional Observations to Study Predictors of Events in the Coronary Tree) study, ACS patients underwent 3-vessel quantitative coronary angiography, grayscale, and radiofrequency intravascular ultrasound after successful percutaneous coronary intervention (PCI). Subsequent MACE (cardiac death or arrest, myocardial infarction, or rehospitalization for unstable or progressive angina) were adjudicated to the originally treated culprit versus untreated nonculprit lesions in 3 patient groups: 1) diabetes; 2) Met Syn; and 3) neither. Median length of follow-up was 3.4 years. RESULTS Of 673 patients, 119 (17.7%) had diabetes and 239 (35.5%) had Met Syn. The cumulative 3-year MACE rate was 29.4% in patients with diabetes, 21.3% with Met Syn, and 17.4% with neither (p = 0.03). MACE adjudicated to untreated nonculprit lesions occurred in 18.7%, 11.7%, and 9.7% of patients, respectively (p = 0.06). Nonculprit lesions in diabetes and Met Syn patients were longer and had greater plaque burden, smaller lumen areas, with greater necrotic core and calcium content. Diabetes and Met Syn patients with future MACE had greater necrotic core and calcification compared with the normal cardiometabolic group. CONCLUSIONS In this PCI ACS population, patients with diabetes and Met Syn had higher 3-year MACE rates. Lesion length, plaque burden, necrotic core, and calcium content were significantly greater among nonculprit lesions of patients with diabetes and Met Syn, but only necrotic core and calcium were significantly greater in the nonculprit lesions of patients with a future MACE in this exploratory analysis.
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Affiliation(s)
- Steven P Marso
- Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, Missouri 64111, USA.
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Kaul S, Diamond GA. Improved prospects for IVUS in identifying vulnerable plaques? JACC Cardiovasc Imaging 2012; 5:S106-10. [PMID: 22421224 DOI: 10.1016/j.jcmg.2012.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Accepted: 02/01/2012] [Indexed: 12/21/2022]
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Coronary plaque composition, morphology, and outcomes in patients with and without chronic kidney disease presenting with acute coronary syndromes. JACC Cardiovasc Imaging 2012; 5:S53-61. [PMID: 22421231 DOI: 10.1016/j.jcmg.2011.12.008] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2011] [Revised: 12/16/2011] [Accepted: 12/30/2011] [Indexed: 01/26/2023]
Abstract
OBJECTIVES This study sought to evaluate the impact of chronic kidney disease (CKD) on coronary atherosclerotic plaque composition, morphology, and outcomes in patients with acute coronary syndromes (ACS). BACKGROUND CKD patients presenting with ACS are at increased risk for adverse events. Whether or not this increased risk reflects differences in coronary plaque composition remains unknown. METHODS In the PROSPECT (Providing Regional Observations to Study Predictors of Events in the Coronary Tree) study, patients presenting with ACS in whom percutaneous coronary intervention was successful underwent 3-vessel grayscale and radiofrequency intravascular ultrasound imaging. Lesions were prospectively characterized, and patients were followed for a median of 3.4 years. We conducted a patient-level and lesion-level analysis of study participants by comparing intravascular ultrasound parameters of untreated nonculprit lesions in patients with and without CKD. RESULTS Patients with CKD (n = 73, 11.3%) were older, more often female and diabetic compared to those without CKD (n = 573). Nonculprit lesions in patients with (n = 280) versus without (n = 2,390) CKD were more likely to have plaque burden ≥ 70% (11.8% vs. 8.5%, p = 0.05) and minimal luminal area ≤ 4.0 mm(2) (25.9% vs. 19.2%, p = 0.005). The percentage of plaque comprised of necrotic core (15.0% vs. 13.0%, p = 0.0001) and dense calcium (8.2% vs. 6.4%, p < 0.0001) was higher while fibrous tissue (57.7% vs. 59.8%, p < 0.0001) was lower in CKD versus non-CKD lesions. The 3-year composite rate of cardiac death, cardiac arrest, or myocardial infarction (15.1% vs. 3.3%, p < 0.0001) was significantly higher in patients with than in those without CKD, although there were no differences in the rates of events adjudicated to nonculprit lesions. CONCLUSIONS Following percutaneous coronary intervention of all culprit lesions in ACS, patients with versus without CKD have more extensive and severe atherosclerosis remaining in their coronary tree with plaque composed of greater necrotic core and less fibrous tissue. These influences resulted in nonsignificantly different rates of non-culprit lesion-related adverse events, although cardiac death, arrest, or myocardial infarction were more common in patients with CKD.
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Gender and the Extent of Coronary Atherosclerosis, Plaque Composition, and Clinical Outcomes in Acute Coronary Syndromes. JACC Cardiovasc Imaging 2012; 5:S62-72. [DOI: 10.1016/j.jcmg.2012.02.003] [Citation(s) in RCA: 203] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2011] [Revised: 01/31/2012] [Accepted: 02/02/2012] [Indexed: 11/22/2022]
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Brugaletta S, Garcia-Garcia HM, Serruys PW, Maehara A, Farooq V, Mintz GS, de Bruyne B, Marso SP, Verheye S, Dudek D, Hamm CW, Farhat N, Schiele F, McPherson J, Lerman A, Moreno PR, Wennerblom B, Fahy M, Templin B, Morel MA, van Es GA, Stone GW. Relationship Between Palpography and Virtual Histology in Patients With Acute Coronary Syndromes. JACC Cardiovasc Imaging 2012; 5:S19-27. [DOI: 10.1016/j.jcmg.2011.02.026] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2010] [Revised: 12/16/2010] [Accepted: 02/14/2011] [Indexed: 11/16/2022]
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Sanidas EA, Mintz GS, Maehara A, Cristea E, Wennerblom B, Iñiguez A, Fajadet J, Fahy M, Dressler O, Weisz G, Templin B, Zhang Z, Lansky AJ, de Bruyne B, Serruys P, Stone GW. Adverse Cardiovascular Events Arising From Atherosclerotic Lesions With and Without Angiographic Disease Progression. JACC Cardiovasc Imaging 2012; 5:S95-S105. [DOI: 10.1016/j.jcmg.2011.08.024] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2011] [Revised: 07/06/2011] [Accepted: 08/18/2011] [Indexed: 10/28/2022]
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Claessen BE, Maehara A, Fahy M, Xu K, Stone GW, Mintz GS. Plaque Composition by Intravascular Ultrasound and Distal Embolization After Percutaneous Coronary Intervention. JACC Cardiovasc Imaging 2012; 5:S111-8. [DOI: 10.1016/j.jcmg.2011.11.018] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2011] [Revised: 10/25/2011] [Accepted: 11/01/2011] [Indexed: 11/16/2022]
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Maehara A, Cristea E, Mintz GS, Lansky AJ, Dressler O, Biro S, Templin B, Virmani R, de Bruyne B, Serruys PW, Stone GW. Definitions and Methodology for the Grayscale and Radiofrequency Intravascular Ultrasound and Coronary Angiographic Analyses. JACC Cardiovasc Imaging 2012; 5:S1-9. [DOI: 10.1016/j.jcmg.2011.11.019] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2011] [Revised: 11/01/2011] [Accepted: 11/03/2011] [Indexed: 10/28/2022]
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McPherson JA, Maehara A, Weisz G, Mintz GS, Cristea E, Mehran R, Foster M, Verheye S, Rabbani L, Xu K, Fahy M, Templin B, Zhang Z, Lansky AJ, de Bruyne B, Serruys PW, Stone GW. Residual Plaque Burden in Patients With Acute Coronary Syndromes After Successful Percutaneous Coronary Intervention. JACC Cardiovasc Imaging 2012; 5:S76-85. [DOI: 10.1016/j.jcmg.2012.01.005] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Accepted: 01/12/2012] [Indexed: 10/28/2022]
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