Impact of Plaque Composition on Long-Term Clinical Outcomes in Patients with Coronary Artery Occlusive Disease.
10.4070/kcj.2013.43.6.377
- Author:
Ki Hong KIM
1
;
Wan Ho KIM
;
Hyun Woong PARK
;
In Girl SONG
;
Dong Ju YANG
;
Young Hoon SEO
;
Hyung Bin YUK
;
Yo Han PARK
;
Taek Geun KWON
;
Charanjit S RIHAL
;
Amir LERMAN
;
Moo Sik LEE
;
Jang Ho BAE
Author Information
1. Division of Cardiology, Konyang University Hospital, Daejeon, Korea. janghobae@yahoo.co.kr
- Publication Type:Original Article
- Keywords:
Intravascular ultrasonography;
Plaque, atherosclerotic;
Coronary artery disease
- MeSH:
Acute Coronary Syndrome;
Coronary Artery Disease;
Coronary Vessels;
Follow-Up Studies;
Glycosaminoglycans;
Humans;
Incidence;
Male;
Myocardial Infarction;
Plaque, Atherosclerotic;
Shock, Cardiogenic;
Ultrasonography, Interventional
- From:Korean Circulation Journal
2013;43(6):377-383
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND AND OBJECTIVES: It is unclear which plaque component is related with long-term clinical outcomes in patients with coronary artery occlusive disease (CAOD). We assessed the relationship between plaque compositions and long-term clinical outcomes in those patients. SUBJECTS AND METHODS: The study subjects consisted of 339 consecutive patients (mean 61.7+/-12.2 years old, 239 males) who underwent coronary angiogram and a virtual histology-intravascular ultrasound examination. Major adverse cardiac and cerebrovascular events (MACCE), including all-cause death, non-fatal myocardial infarction, cerebrovascular events, and target vessel revascularization were evaluated during a mean 28-month follow-up period. RESULTS: Patients with high fibrofatty volume (FFV, >8.90 mm3, n=169) had a higher incidence of MACCE (25.4% vs. 14.7%, p=0.015), male sex (75.7% vs. 65.3%, p=0.043), acute coronary syndrome (53.3% vs. 35.9%, p=0.002), multivessel disease (62.7% vs. 41.8%, p<0.001) and post-stent slow flow (10.7% vs. 2.4%, p=0.002) than those with low FFV (FFV< or =8.90 mm3, n=170). Other plaque composition factors such as fibrous area/volume, dense calcified area/volume, and necrotic core area/volume did not show any impact on MACCE. Cardiogenic shock {hazard ratio (HR)=8.44; 95% confidence interval (CI)=3.00-23.79; p<0.001} and FFV (HR=1.85; 95% CI=1.12-3.07; p=0.016) were the independent predictors of MACCE by Cox regression analysis. Thin-cap fibroatheroma, necrotic core area, and necrotic core volume were not associated with MACCE. CONCLUSION: FFV of a culprit lesion was associated with unfavorable long-term clinical outcomes in patients with CAOD.
