Morphological Plaque Characteristics and Clinical Outcomes in Patients With Acute Coronary Syndrome and a Cancer History

Autor: Koji Kuroda, Akira Nagasawa, Masamichi Iwasaki, Hiroyuki Kawamori, Yusuke Fukuyama, Amane Kozuki, Ken-ichi Hirata, Kosuke Tanimura, Yu Takahashi, Shinsuke Nakano, Tomofumi Takaya, Junya Shite, Takayoshi Toba, Hiromasa Otake
Rok vydání: 2021
Předmět:
Male
medicine.medical_specialty
Acute coronary syndrome
Etiology
medicine.medical_treatment
Comorbidity
030204 cardiovascular system & hematology
Risk Assessment
plaque morphology
Culprit
Imaging
acute coronary syndrome
03 medical and health sciences
Percutaneous Coronary Intervention
Postoperative Complications
0302 clinical medicine
Japan
Risk Factors
Neoplasms
Internal medicine
medicine
Humans
Optical Coherence Tomography (OCT)
030212 general & internal medicine
Aged
Original Research
optical coherence tomography
Rupture
Spontaneous
business.industry
Incidence (epidemiology)
Remission Induction
cancer history
Hazard ratio
Percutaneous coronary intervention
Cancer
Odds ratio
medicine.disease
Plaque
Atherosclerotic
Surgery
Computer-Assisted
Cardio-Oncology
Female
Cardiology and Cardiovascular Medicine
business
Acute Coronary Syndromes
Tomography
Optical Coherence
Cohort study
Zdroj: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
ISSN: 2047-9980
DOI: 10.1161/jaha.120.020243
Popis: Background Although patients with a cancer history have a 2 to 3 times higher risk for acute coronary syndrome (ACS), the morphological characteristics of ACS culprit plaque in those patients and their relations with clinical outcomes remain unknown. Methods and Results This retrospective, multicenter, observational cohort study included consecutive patients with ACS who underwent optical coherence tomography‐guided emergent percutaneous coronary intervention. Patients were categorized into those without a cancer history, those with a cancer history, and those currently receiving cancer treatment. ACS culprit lesions were classified as plaque rupture, plaque erosion, or calcified nodule using optical coherence tomography. Plaque erosion frequency was significantly higher in culprit lesions of patients with current cancer and patients with cancer history than in those of patients without cancer history (56.3% versus 61.7% versus 36.5%). Calcified nodule incidence was significantly higher in patients without cancer history than in patients with current cancer and patients without cancer history (patients with current cancer: 12.4% versus patients without cancer history: 25.5% versus patients without cancer history: 12.6%, P P P =0.002). Nonplaque rupture in ACS culprit lesions was independently associated with major adverse cardiovascular events (HR, 1.60; P =0.011). Conclusions Patients with a cancer history had significantly worse clinical outcomes after ACS than those without a cancer history. Those with a cancer history had significantly higher plaque erosion and calcified nodule incidences in the ACS culprit lesions, which might partly explain their worse clinical outcomes. Registration URL: www.umin.ac.jp/ctr/index.htm . Unique Identifier: UMIN000038442.
Databáze: OpenAIRE
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