Impact of plaque composition on long-term clinical outcomes in patients with coronary artery occlusive disease

Ki Hong Kim, Wan Ho Kim, Hyun Woong Park, In Girl Song, Dong Ju Yang, Young Hoon Seo, Hyung Bin Yuk, Yo Han Park, Taek Geun Kwon, Charanjit S. Rihal, Amir Lerman, Moo Sik Lee, Jang Ho Bae

Research output: Contribution to journalArticle

7 Scopus citations

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 617±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 mm3, 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 mm3, 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.

Original languageEnglish (US)
Pages (from-to)377-383
Number of pages7
JournalKorean Circulation Journal
Volume43
Issue number6
DOIs
StatePublished - Jun 1 2013

Keywords

  • Atherosclerotic
  • Coronary artery disease
  • Intravascular ultrasonography
  • Plaque

ASJC Scopus subject areas

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine

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    Kim, K. H., Kim, W. H., Park, H. W., Song, I. G., Yang, D. J., Seo, Y. H., Yuk, H. B., Park, Y. H., Kwon, T. G., Rihal, C. S., Lerman, A., Lee, M. S., & Bae, J. H. (2013). Impact of plaque composition on long-term clinical outcomes in patients with coronary artery occlusive disease. Korean Circulation Journal, 43(6), 377-383. https://doi.org/10.4070/kcj.2013.43.6.377