Author + information
- Dong Ju Yang,
- Ki Hong Kim,
- Hyun Woong Park,
- Wan Ho Kim,
- In Girl Song,
- Chung Seop Lee,
- Young Hoon Seo,
- Taek Geun Kwon and
- Jang–Ho Bae
Until now, it is unclear that each plaque components is related with long term clinical outcomes. We assessed relationship between plaque compositions and long term clinical outcomes.
The study subjects consisted of 339 consecutive patients (mean age, 61.7±12.2 years; 239 males) who underwent coronary angiogram and virtual histology–intravascular ultrasound examination. Major adverse cardiac events (MACEs) including death, acute myocardial infarction, stroke and target vessel revascularization were evaluated during the mean 51 months follow–up period. To evaluate the effect of plaque compositional area and volume to clinical outcomes, we defined high area and volume criteria as like this; high plaque area or volume (PA/PV) (≥70% of external elastic lamina area or volume), high fibrous area or volume (≥50% of PA/PV), high fibro–fatty area or volume (FFA/FFV) (≥10% of PA/PV), high dense calcium area or volume (≥10% of PA/PV) and high necrotic core area or volume (≥10% of PA/PV).
Cardiogenic shock (HR=8.70; 95% CI=3.15–21.10; p<0.001) and high FFV (HR=1.86; 95% CI=1.20–2.88; p=0.006) were only independent predictors for MACEs by Cox regression analysis. Patients with high FFV had a higher incidence of MACEs (33.0% vs. 19.6%, p=0.009), older age (64.3±12.1 vs. 60.5±12.1, p=0.008), larger minimal lumen area (4.2±1.2 mm2vs. 3.8±1.2 mm2, p=0.020), higher plaque burden (61.4±7.7% vs. 56.0±8.0%, p<0.001), higher plaque volume (217.4±120.8 mm3vs. 155.4±98.2 mm3, p<0.001), less thin–cap fibroatheroma (48.9% vs. 29.0%, p=0.001). Fibrous area/volume, FFA, dense calcium area/volume and necrotic core area/volume did not affect to MACEs.
FFV rather than necrotic core volume was important in long–term clinical outcomes in patients who had coronary occlusive disease.
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.–4:30 p.m.
Session Title: Chronic Total Occlusions
Abstract Category: 38. TCT@ACC–i2: Intravascular Imaging and Physiology
Presentation Number: 2103–241
- 2013 American College of Cardiology Foundation