Fibro-Fatty Component is Important for the Long-Term Clinical Events in Patients Who Have Undergone Primary Percutaneous Coronary Intervention.
- Author:
Wan Ho KIM
1
;
Hyun Woong PARK
;
Ki Hong KIM
;
In Girl SONG
;
Dong Ju YANG
;
Chung Seop LEE
;
Young Hoon SEO
;
Taek Geun KWON
;
Jang Ho BAE
Author Information
- Publication Type:Original Article
- Keywords: Intravascular ultrasonography; Myocardial infarction; Disease-free survival
- MeSH: Demography; Disease-Free Survival; Follow-Up Studies; Humans; Incidence; Myocardial Infarction; Percutaneous Coronary Intervention; Stroke; Ultrasonography, Interventional
- From:Korean Circulation Journal 2012;42(1):33-39
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND AND OBJECTIVES: We evaluated which plaque components are associated with long-term clinical events in patients who underwent primary percutaneous coronary intervention (PCI). SUBJECTS AND METHODS: The study subjects consisted of 57 consecutive patients (mean age, 58.5+/-14.5 years; 45 males) who underwent primary PCI and a virtual histology-intravascular ultrasound examination. Major adverse cardiac events (MACEs) including death, acute myocardial infarction, stroke, and revascularization were evaluated during the mean 28 month follow-up period. RESULTS: Patients with high fibro-fatty volume (FFV >13.4 mm3, n=29; mean age, 61.3 years) had a lower ejection fraction (52.7% vs. 59.4%, p=0.022), a higher incidence of multi-vessel disease (69.0% vs. 28.6%, p=0.002), larger plaque area (25.7 mm2 vs. 15.9 mm2, p<0.001), and larger plaque volume (315 mm3 vs. 142 mm3, p<0.001) than those with a low FFV (< or =13.4 mm3, n=28; mean age, 55.6 years). Patients with high FFV had a significantly higher incidence (32.1% vs. 8.3%, p=0.036) of MACE than those with low FFV. When we divided the study population according to the necrotic core volume (NCV), fibrous volume, or dense calcified volume, no significant findings in terms of demographics and MACE rates were observed. A Cox regression analysis revealed that the independent factor for MACE was FFV (hazard ratio, 6.748; 95% confidence interval, 1.168-38.971, p=0.033) in this study population. CONCLUSION: The coronary plaque component, particularly FFV, but not NCV, was important in long-term clinical outcomes in patients who underwent primary PCI.
