Relationship between coronary plaque morphology of the left anterior descending artery and 12 months clinical outcome: the CLIMA study.

Autor:	Prati F; Cardiovascular Sciences Department, San Giovanni Addolorata Hospital, Rome, Italy.; Centro per la Lotta Contro L'Infarto - CLI Foundation, Rome, Italy., Romagnoli E; Centro per la Lotta Contro L'Infarto - CLI Foundation, Rome, Italy.; Department of Cardiovascular and Thoracic Sciences, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy., Gatto L; Cardiovascular Sciences Department, San Giovanni Addolorata Hospital, Rome, Italy.; Centro per la Lotta Contro L'Infarto - CLI Foundation, Rome, Italy., La Manna A; Cardio-Thoracic-Vascular Department, Azienda Ospedaliero-Universitaria 'Policlinico-Vittorio Emanuele', University of Catania, Catania, Italy., Burzotta F; Department of Cardiovascular and Thoracic Sciences, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy., Ozaki Y; Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan., Marco V; Centro per la Lotta Contro L'Infarto - CLI Foundation, Rome, Italy., Boi A; Interventional Cardiology Unit, Ospedale Brotzu, Cagliari, Italy., Fineschi M; Department of Cardiovascular Diseases, Azienda Ospedaliera Universitaria Senese, Siena, Italy., Fabbiocchi F; Centro Cardiologico Monzino IRCCS, Milano., Taglieri N; Cardio-Thoracic-Vascular Department, University Hospital of Bologna, Bologna, Italy., Niccoli G; Department of Cardiovascular and Thoracic Sciences, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy., Trani C; Department of Cardiovascular and Thoracic Sciences, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy., Versaci F; Cardiology Department, Santa Maria Goretti Hospital, Latina, Italy., Calligaris G; Centro Cardiologico Monzino IRCCS, Milano., Ruscica G; Cardio-Thoracic-Vascular Department, Azienda Ospedaliero-Universitaria 'Policlinico-Vittorio Emanuele', University of Catania, Catania, Italy., Di Giorgio A; Interventional Cardiology Unit, Policlinico G Martino, Messina., Vergallo R; Department of Cardiovascular and Thoracic Sciences, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy., Albertucci M; Cardiovascular Sciences Department, San Giovanni Addolorata Hospital, Rome, Italy.; Centro per la Lotta Contro L'Infarto - CLI Foundation, Rome, Italy., Biondi-Zoccai G; Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy.; Mediterranea Cardiocentro, Napoli, Italy., Tamburino C; Cardio-Thoracic-Vascular Department, Azienda Ospedaliero-Universitaria 'Policlinico-Vittorio Emanuele', University of Catania, Catania, Italy., Crea F; Department of Cardiovascular and Thoracic Sciences, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy., Alfonso F; Department of Cardiology, Hospital Universitario de La Princesa, Madrid, Spain., Arbustini E; Centre for Inherited Cardiovascular Diseases, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy.
Jazyk:	angličtina
Zdroj:	European heart journal [Eur Heart J] 2020 Jan 14; Vol. 41 (3), pp. 383-391.
DOI:	10.1093/eurheartj/ehz520
Abstrakt:	Aims: The CLIMA study, on the relationship between coronary plaque morphology of the left anterior descending artery and twelve months clinical outcome, was designed to explore the predictive value of multiple high-risk plaque features in the same coronary lesion [minimum lumen area (MLA), fibrous cap thickness (FCT), lipid arc circumferential extension, and presence of optical coherence tomography (OCT)-defined macrophages] as detected by OCT. Composite of cardiac death and target segment myocardial infarction was the primary clinical endpoint. Methods and Results: From January 2013 to December 2016, 1003 patients undergoing OCT evaluation of the untreated proximal left anterior descending coronary artery in the context of clinically indicated coronary angiogram were prospectively enrolled at 11 independent centres (clinicaltrial.gov identifier NCT02883088). At 1-year, the primary clinical endpoint was observed in 37 patients (3.7%). In a total of 1776 lipid plaques, presence of MLA <3.5 mm2 [hazard ratio (HR) 2.1, 95% confidence interval (CI) 1.1-4.0], FCT <75 µm (HR 4.7, 95% CI 2.4-9.0), lipid arc circumferential extension >180° (HR 2.4, 95% CI 1.2-4.8), and OCT-defined macrophages (HR 2.7, 95% CI 1.2-6.1) were all associated with increased risk of the primary endpoint. The pre-specified combination of plaque features (simultaneous presence of the four OCT criteria in the same plaque) was observed in 18.9% of patients experiencing the primary endpoint and was an independent predictor of events (HR 7.54, 95% CI 3.1-18.6). Conclusion: The simultaneous presence of four high-risk OCT plaque features was found to be associated with a higher risk of major coronary events. (© The Author(s) 2019. Published by Oxford University Press on behalf of the European Society of Cardiology.)
Databáze:	MEDLINE
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