Lipid-rich large plaques in a non-culprit left main coronary artery and long-term clinical outcomes
| Autor: | Kenji Furusawa, Hideki Ishii, Toyoaki Murohara, Keisuke Sakakibara, Hiroshi Tashiro, Akihiro Tobe, Akihito Tanaka, Yusuke Hitora, Takashi Kataoka, Kiyoshi Niwa, Yusuke Miki |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Coronary Artery Disease 030204 cardiovascular system & hematology medicine.disease_cause Revascularization Culprit 03 medical and health sciences Percutaneous Coronary Intervention 0302 clinical medicine Internal medicine Intravascular ultrasound medicine Humans cardiovascular diseases 030212 general & internal medicine Myocardial infarction Ultrasonography Interventional Aged medicine.diagnostic_test business.industry Percutaneous coronary intervention Middle Aged medicine.disease Coronary Vessels Lipids Vulnerable plaque Plaque Atherosclerotic Conventional PCI Cardiology Female Cardiology and Cardiovascular Medicine business Mace |
| Zdroj: | International Journal of Cardiology. 305:5-10 |
| ISSN: | 0167-5273 |
| DOI: | 10.1016/j.ijcard.2020.01.072 |
| Popis: | Background An integrated backscatter (IB) intravascular ultrasound (IVUS) provides an information about tissue components and vulnerability of coronary plaques. The presence of vulnerable plaque in non-culprit lesion is associated with future clinical events. The purpose of this study was to assess the association between the characteristics of non-culprit left main coronary artery (LMCA) plaques evaluated by IB-IVUS and long-term clinical outcomes in patients undergoing percutaneous coronary intervention (PCI). Methods Among the patients who underwent non-LMCA PCI, we studied 366 patients with adequate LMCA IVUS images. Conventional and IB-IVUS analyses of the LMCA segment were performed. Lipid-rich large plaque was defined as the presence of both a lager plaque volume and a higher percentage of the lipid component than the obtained median values. Major adverse cardiovascular events (MACE) included cardiac death, myocardial infarction, and unplanned revascularization. Results The mean age of the patients was 68.5 ± 10.2 years, 79.8% were men. Median follow-up period was 6.0 years (IQR: 4.2–8.1 years). The incidence of MACE was significantly higher in patients with lipid-rich large plaques (P = .006). The incidence rates of cardiac death, myocardial infarction, and unplanned revascularization were significantly higher in patients with lipid-rich large plaques (P = .02, 0.004, and 0.02, respectively). Multivariate Cox regression analysis showed that the presence of a lipid-rich large plaque was significantly associated with MACE (HR: 1.74; 95%CI: 1.17–2.58; P = .006). Conclusion The presence of lipid-rich large plaques in a non-culprit LMCA can be associated with the long-term MACE in patients who have undergone PCI. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect