Serial Optical Coherence Tomography Assessment of Coronary Atherosclerosis and Long-Term Clinical Outcomes.

Autor: Yamaji K; Department of Cardiovascular Medicine Kyoto University Graduate School of Medicine Kyoto Japan.; Department of Cardiology Kokura Memorial Hospital Kitakyushu Japan., Kanenawa K; Department of Cardiology Kokura Memorial Hospital Kitakyushu Japan., Morofuji T; Department of Cardiology Kokura Memorial Hospital Kitakyushu Japan., Nishikawa R; Department of Cardiovascular Medicine Kyoto University Graduate School of Medicine Kyoto Japan., Imada K; Department of Cardiovascular Medicine Kyoto University Graduate School of Medicine Kyoto Japan.; Department of Cardiology Kokura Memorial Hospital Kitakyushu Japan., Kohjitani H; Department of Cardiovascular Medicine Kyoto University Graduate School of Medicine Kyoto Japan., Watanabe H; Department of Cardiology Japanese Red Cross Wakayama Medical Center Wakayama Japan., Tazaki J; Department of Cardiology Japanese Red Cross Wakayama Medical Center Wakayama Japan., Taniwaki M; Department of Cardiology Tokorozawa Heart Center Tokorozawa Japan., Koga S; Department of Cardiovascular Medicine Nagasaki University Graduate School of Biomedical Sciences Nagasaki Japan., Akashi R; Department of Cardiovascular Medicine Nagasaki University Graduate School of Biomedical Sciences Nagasaki Japan., Kubo S; Department of Cardiology Kurashiki Central Hospital Kurashiki Japan., Ohya M; Department of Cardiology Kurashiki Central Hospital Kurashiki Japan., Kikuchi T; Division of Cardiology Edogawa Hospital Tokyo Japan., Ohira H; Division of Cardiology Edogawa Hospital Tokyo Japan., Numasawa Y; Department of Cardiology Japanese Red Cross Ashikaga Hospital Ashikaga Japan., Arikawa M; Department of Cardiology National Hospital Organization Oita Medical Center Yokota Oita Japan., Iwama M; Department of Cardiology Gifu Prefectural General Medical Center Gifu Japan., Kitai T; Department of Cardiovascular Medicine Kobe City Medical Center General Hospital Kobe Japan.; Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan., Kobayashi Y; Department of Cardiology Osaka Red Cross Hospital Osaka Japan., Shiomi H; Department of Cardiovascular Medicine Kyoto University Graduate School of Medicine Kyoto Japan., Tada T; Department of Cardiology Shizuoka General Hospital Shizuoka Japan., Yamaji Y; Department of Cardiology The Tazuke Kofukai Medical Research Institute, Kitano Hospital Osaka Japan., Daidoji H; Department of Cardiology Yamagata Prefectural Central Hospital Yamagata Japan., Ohtani H; Department of Cardiology, Internal Medicine 3 Hamamatsu University School of Medicine Hamamatsu Japan., Furukawa Y; Department of Cardiovascular Medicine Kobe City Medical Center General Hospital Kobe Japan., Kadota K; Department of Cardiology Kurashiki Central Hospital Kurashiki Japan., Toyofuku M; Department of Cardiology Japanese Red Cross Wakayama Medical Center Wakayama Japan., Ando K; Department of Cardiology Kokura Memorial Hospital Kitakyushu Japan., Ono K; Department of Cardiovascular Medicine Kyoto University Graduate School of Medicine Kyoto Japan., Kimura T; Department of Cardiovascular Medicine Kyoto University Graduate School of Medicine Kyoto Japan.; Division of Cardiology Hirakata Kohsai Hospital Osaka Japan.
Jazyk: angličtina
Zdroj: Journal of the American Heart Association [J Am Heart Assoc] 2024 Nov 05; Vol. 13 (21), pp. e034458. Date of Electronic Publication: 2024 Oct 22.
DOI: 10.1161/JAHA.123.034458
Abstrakt: Background: The impact of high-risk coronary artery plaques identified using optical coherence tomography on late luminal narrowing and clinical events remains poorly understood.
Methods and Results: This multicenter prospective study included 176 patients who underwent percutaneous coronary intervention and serial optical coherence tomography at baseline and 1-year follow-up to investigate nontarget regions with angiographically intermediate stenosis. At 1 year after percutaneous coronary intervention, the coronary artery lumen area decreased significantly from 6.06 (95% CI, 5.60-6.53) mm 2 to 5.88 (95% CI, 5.41-6.35) mm 2 (difference, -0.18; 95% CI, -0.22 to -0.14 mm 2 ; P <0.001), particularly in thin-cap fibroatheromas, thick-cap fibroatheromas, mixed plaques, and fibrous plaques. The prevalence of fibroatheroma decreased from 38% to 36% ( P <0.001), whereas calcified plaque increased from 31% to 34% ( P <0.001), accompanied by a significant increase in calcium thickness and angle. Diabetes and current smoking habits were independently associated with increasing calcium prevalence. Patients with thin-cap fibroatheroma had a significantly higher 3-year risk of ischemia-driven nontarget vessel revascularization (hazard ratio, 2.42 [95% CI, 1.03-5.71]; P =0.04), primarily due to revascularization in the imaged region. No significant association was observed between coronary artery calcium prevalence and clinical outcomes within 3 years.
Conclusions: The coronary artery lumen area significantly decreased over a 1-year interval, particularly in thin-cap fibroatheromas, thick-cap fibroatheromas, mixed plaques, and fibrous plaques. Although thin-cap fibroatheroma prevalence was associated with higher risk of ischemia-driven nontarget vessel revascularization, no significant association was noted between coronary artery calcium prevalence and clinical outcomes within 3 years. The interaction between calcium progression and long-term clinical events necessitates further investigation.
Registration: URL: https://www.umin.ac.jp/ctr/; Unique Identifier: UMIN000031937.
Databáze: MEDLINE
Externí odkaz: