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Background: Magnetic resonance T1-weighted imaging (T1WI) enables assessment of coronary vulnerable morphology as high-intensity plaque (HIP). The purpose of this study was to investigate the prognostic value of HIP at the culprit lesion on noncontrast T1WI among patients who underwent optical coherence tomography (OCT) guided percutaneous coronary intervention (PCI).
Methods and Results: The study group consisted of 103 patients with angina pectoris undergoing noncontrast T1WI before PCI. During the follow-up period (median 933 days), major adverse cardiac and cerebrovascular events (MACCE) were observed in 23 patients. According to the presence and localization of HIP at the culprit lesion, patients were divided into 3 groups: non-HIPs (signal intensity of coronary plaque to muscle ratio (PMR) <1.4, n=58); intrawall HIPs (PMR ≥1.4 and localized within the coronary wall, n=21); and intraluminal HIPs (PMR ≥1.4 and occupied the lumen, n=24). Kaplan-Meier curve revealed that intraluminal HIPs had significantly higher rate of MACCE than non-HIPs (log-rank p=0.003) (Figure). Multivariate Cox regression analysis identified the presence of intraluminal HIP, which correlated with OCT derived thrombus in multivariate logistic regression analysis (p=0.001), as the significant independent predictor of MACCE (hazard ratio: 3.26; p=0.037) after adjustment for predictive covariates.
Conclusions: The culprit lesion with intraluminal HIP was identified as an independent predictor of MACCE after PCI.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Non Invasive Imaging: MR Structure and Valuvular Heart Disease
Abstract Category: 29. Non Invasive Imaging: MR
Presentation Number: 1290-216
- 2017 American College of Cardiology Foundation