Kim KH, Kim WH, Park HW, Song IG, Yang DJ, Seo YH, Yuk HB, Park YH, Kwon TG, Rihal CS, Lerman A, Lee MS, Bae JH. Impact of plaque composition on long-term clinical outcomes in patients with coronary artery occlusive disease.
Korean Circ J 2013;
43:377-83. [PMID:
23882286 PMCID:
PMC3717420 DOI:
10.4070/kcj.2013.43.6.377]
[Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 05/20/2013] [Accepted: 05/31/2013] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND AND OBJECTIVES
It is unclear which plaque component is related with long-term clinical outcomes in patients with coronary artery occlusive disease (CAOD). We assessed the relationship between plaque compositions and long-term clinical outcomes in those patients.
SUBJECTS AND METHODS
The study subjects consisted of 339 consecutive patients (mean 61.7±12.2 years old, 239 males) who underwent coronary angiogram and a virtual histology-intravascular ultrasound examination. Major adverse cardiac and cerebrovascular events (MACCE), including all-cause death, non-fatal myocardial infarction, cerebrovascular events, and target vessel revascularization were evaluated during a mean 28-month follow-up period.
RESULTS
Patients with high fibrofatty volume (FFV, >8.90 mm(3), n=169) had a higher incidence of MACCE (25.4% vs. 14.7%, p=0.015), male sex (75.7% vs. 65.3%, p=0.043), acute coronary syndrome (53.3% vs. 35.9%, p=0.002), multivessel disease (62.7% vs. 41.8%, p<0.001) and post-stent slow flow (10.7% vs. 2.4%, p=0.002) than those with low FFV (FFV≤8.90 mm(3), n=170). Other plaque composition factors such as fibrous area/volume, dense calcified area/volume, and necrotic core area/volume did not show any impact on MACCE. Cardiogenic shock {hazard ratio (HR)=8.44; 95% confidence interval (CI)=3.00-23.79; p<0.001} and FFV (HR=1.85; 95% CI=1.12-3.07; p=0.016) were the independent predictors of MACCE by Cox regression analysis. Thin-cap fibroatheroma, necrotic core area, and necrotic core volume were not associated with MACCE.
CONCLUSION
FFV of a culprit lesion was associated with unfavorable long-term clinical outcomes in patients with CAOD.
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