Abstract |
The present study explored the predictive value of culprit high-risk plaque (HRP) detected by optical coherence tomography (OCT) for predicting major adverse cardiovascular events (MACEs) in patients with ST-segment elevation myocardial infarction ( STEMI). HRP was defined as the simultaneous presence of four criteria: minimum lumen area <3.5 mm2, fibrous cap thickness <75 μm, lipid plaque with lipid arc extension >180°, and presence of macrophages. Patients (n = 274) were divided into non-HRP group (n = 206) and HRP group (n = 68). MACEs were defined as a composite of all-cause death, myocardial infarction, stroke, and revascularization. During a mean follow-up of 2.2 years, 47 (17.5%) MACEs were observed: 28 (13.6%) in the non-HRP group and 19 (27.9%) in the HRP group (log-rank P = .005). Patients with HRP were 2.05 times more likely to suffer from a MACE than those without HRP (hazards ratio: 2.05, 95% confidence interval: 1.04-4.02, P = .038); MACE risk was comparable between plaque rupture and plaque erosion. In conclusion, HRP was present in 24.8% of STEMI patients and associated with higher cardiovascular risk independent of plaque rupture, suggesting that HRP detected by OCT may help identify patients at high risk of future cardiac events.
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Authors | Ying Wang, Xiaoxiao Zhao, Peng Zhou, Chen Liu, Zhiyong Liao, Xiaoqing Wang, Shaodi Yan, Zhaoxue Sheng, Jiannan Li, Jinying Zhou, Runzhen Chen, Yi Chen, Li Song, Hanjun Zhao, Hongbing Yan |
Journal | Angiology
(Angiology)
2022 Nov-Dec
Vol. 73
Issue 10
Pg. 946-955
ISSN: 1940-1574 [Electronic] United States |
PMID | 35506476
(Publication Type: Journal Article)
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Chemical References |
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Topics |
- Coronary Angiography
(adverse effects)
- Coronary Vessels
(diagnostic imaging)
- Humans
- Lipids
- Myocardial Infarction
(etiology)
- Percutaneous Coronary Intervention
(adverse effects)
- Plaque, Atherosclerotic
(complications)
- ST Elevation Myocardial Infarction
(complications, diagnostic imaging, therapy)
- Tomography, Optical Coherence
(adverse effects, methods)
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