Independent role of atherosclerotic plaque composition and extension in predicting the risk of cardiac events: a CLIMA substudy.

Autor: Budassi S; Cardiology Department, San Giovanni Addolorata Hospital, Via dell'Amba Aradam, 8, Rome, 00184, Italy.; Centro Lotta all'Infarto (CLI) Foundation, Rome, Italy., Biccirè FG; Cardiology Department, San Giovanni Addolorata Hospital, Via dell'Amba Aradam, 8, Rome, 00184, Italy.; Centro Lotta all'Infarto (CLI) Foundation, Rome, Italy.; Department of General and Specialized Surgery 'Paride Stefanini', Sapienza University of Rome, Rome, Italy., Gatto L; Cardiology Department, San Giovanni Addolorata Hospital, Via dell'Amba Aradam, 8, Rome, 00184, Italy.; Centro Lotta all'Infarto (CLI) Foundation, Rome, Italy., Scorza M; Centro Lotta all'Infarto (CLI) Foundation, Rome, Italy., Marco V; Centro Lotta all'Infarto (CLI) Foundation, Rome, Italy., Porta Y; Centro Lotta all'Infarto (CLI) Foundation, Rome, Italy.; Department of Cardiovascular Sciences, Campus Biomedico University, Rome, Italy., Sammartini E; Centro Lotta all'Infarto (CLI) Foundation, Rome, Italy., Paoletti G; Centro Lotta all'Infarto (CLI) Foundation, Rome, Italy., Debelak C; Centro Lotta all'Infarto (CLI) Foundation, Rome, Italy., Di Pietro R; Cardiology Department, San Giovanni Addolorata Hospital, Via dell'Amba Aradam, 8, Rome, 00184, Italy.; Centro Lotta all'Infarto (CLI) Foundation, Rome, Italy., Circhetta S; Centro Lotta all'Infarto (CLI) Foundation, Rome, Italy., Albertucci M; Cardiology Department, San Giovanni Addolorata Hospital, Via dell'Amba Aradam, 8, Rome, 00184, Italy.; Centro Lotta all'Infarto (CLI) Foundation, Rome, Italy., Burzotta F; Departement of Cardiovascular and Thoracic Sciences, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy., Ozaki Y; Fujita Health University Hospital, Toyoake, Japan., Canova PA; Papa Giovanni XXIII Hospital, Bergamo, Italy., Piedimonte G; Interventional Cardiology Departement, Infermi Hospital, Rivoli, Turin, 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., Prati F; Cardiology Department, San Giovanni Addolorata Hospital, Via dell'Amba Aradam, 8, Rome, 00184, Italy. fprati@hsangiovanni.roma.it.; Centro Lotta all'Infarto (CLI) Foundation, Rome, Italy. fprati@hsangiovanni.roma.it.; Saint Camillus International Medical University, Rome, Italy. fprati@hsangiovanni.roma.it.
Jazyk: angličtina
Zdroj: The international journal of cardiovascular imaging [Int J Cardiovasc Imaging] 2024 Oct 21. Date of Electronic Publication: 2024 Oct 21.
DOI: 10.1007/s10554-024-03260-2
Abstrakt: To investigate two different approaches to determine patient risk to develop cardiac events: the burden of coronary atherosclerosis, as assessed by the Gensini score, and plaque morphology, as assessed by intracoronary optical coherence tomography (OCT). We assessed the Gensini score and OCT features of plaque vulnerability in 847 patients from the CLIMA registry. Patients were divided into four Gensini quartiles. The main study endpoint was the 1-year composite of cardiac death, myocardial infarction (MI) and/or target vessel revascularization (TVR). A total of 56 patients (6.6%) experienced the one-year main composite endpoint. The composite endpoint was significantly affected by the Gensini score (hazard ratio [HR] 1.42, 95% confidence interval [CI] 1.11-1.81, p = 0.005), with a low incidence in the first Gensini quartile (Q1 1.3%) and a higher incidence in the remaining groups (Q2 8.3%, Q3 8.9% and Q4 8.3%). At the multivariable analysis, the combined four OCT criteria (HR 6.4, 95%CI 3.0-13.7, p < 0.001), thin fibrous cap (HR 2.9, 95%CI 1.7-5.0, p < 0.001), lipid arc > 180° (HR 2.1, 95%CI 1.2-3.6, p = 0.010), minimum lumen area < 3.5 mm 2 (HR 1.7, 95%CI 1.01-3.0, p = 0.047) and the Gensini score (HR 1.4, 95%CI 1.1-1.8, p = 0.017) were independent predictors of the main composite endpoint. In this post-hoc analysis of the CLIMA study, the burden of coronary atherosclerosis as assessed by the Gensini score and OCT plaque characteristics were independent predictors of cardiac events. Patients with the largest atherosclerosis burden and with plaque vulnerability by OCT were at the highest risk of poor outcome. Clinicaltrials.gov identifier: NCT02883088.
(© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)
Databáze: MEDLINE
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