Significant association among residual SYNTAX score, non-culprit major adverse cardiac events, and greyscale and virtual histology intravascular ultrasound findings: a substudy from the PROSPECT study
| Autor: | Tadayuki Kadohira, Akiko Fujino, Björn Redfors, Akiko Maehara, Philippe Généreux, Gregg W. Stone, Gary S. Mintz, Patrick W. Serruys |
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| Rok vydání: | 2019 |
| Předmět: |
Acute coronary syndrome
medicine.medical_specialty Lumen (anatomy) Coronary Artery Disease 030204 cardiovascular system & hematology Coronary Angiography Culprit Lesion Angina Coronary artery disease 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Angina Unstable cardiovascular diseases 030212 general & internal medicine Myocardial infarction Acute Coronary Syndrome Ultrasonography Interventional business.industry medicine.disease Plaque Atherosclerotic Cardiology medicine.symptom Cardiology and Cardiovascular Medicine business Mace |
| Zdroj: | EuroIntervention. 14:1676-1684 |
| ISSN: | 1774-024X |
| Popis: | Aims Residual SYNTAX score (rSS) is known to be associated with cardiac events. We sought to investigate the association between rSS and greyscale and virtual histology (VH)-intravascular ultrasound (IVUS) plaque morphology, and the association between rSS and non-culprit-related major adverse cardiac events (MACE) using data from the PROSPECT study. Methods and results A total of 697 patients with acute coronary syndromes were enrolled in the PROSPECT study. Three-vessel greyscale and VH-IVUS were performed. Among them, 688 patients with paired baseline SS or SYNTAX score and rSS were identified and divided into three groups - rSS=0 (n=184), 0 8 (n=140). MACE was defined as the composite of cardiac death, cardiac arrest, myocardial infarction, or rehospitalisation for unstable or progressive angina. There was a significant difference in the three-year non-culprit-related MACE rates among the three groups (5.7% versus 11.9% versus 19.7%, lowest to highest rSS; p=0.004) mainly due to rehospitalisation for unstable or progressive angina. On multivariable analysis, patients with ≥1 lesion with plaque burden ≥70% or ≥1 lesion with a minimum lumen area ≤4 mm2 and total dense calcium volume per patient were significantly correlated with rSS. Insulin-treated diabetes mellitus, rSS, and patients with ≥1 lesion with plaque burden ≥70% were independent predictors of non-culprit-related MACE. Conclusions Plaque morphology based on greyscale IVUS and VH-IVUS was significantly correlated with rSS, and rSS and plaque burden ≥70% independently predicted non-culprit-related MACE. |
| Databáze: | OpenAIRE |
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