TY - JOUR
T1 - Impact of plaque composition on long-term clinical outcomes in patients with coronary artery occlusive disease
AU - Kim, Ki Hong
AU - Kim, Wan Ho
AU - Park, Hyun Woong
AU - Song, In Girl
AU - Yang, Dong Ju
AU - Seo, Young Hoon
AU - Yuk, Hyung Bin
AU - Park, Yo Han
AU - Kwon, Taek Geun
AU - Rihal, Charanjit S.
AU - Lerman, Amir
AU - Lee, Moo Sik
AU - Bae, Jang Ho
PY - 2013/6
Y1 - 2013/6
N2 - 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.
AB - 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.
KW - Atherosclerotic
KW - Coronary artery disease
KW - Intravascular ultrasonography
KW - Plaque
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U2 - 10.4070/kcj.2013.43.6.377
DO - 10.4070/kcj.2013.43.6.377
M3 - Article
C2 - 23882286
AN - SCOPUS:84881248369
VL - 43
SP - 377
EP - 383
JO - Korean Circulation Journal
JF - Korean Circulation Journal
SN - 1738-5520
IS - 6
ER -