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Clinical outcomes of low-intensity area without attenuation and cholesterol crystals in non-culprit lesions assessed by optical coherence tomography.
Usui, Eisuke; Matsumura, Mitsuaki; Mintz, Gary S; Zhou, Zhipeng; Hada, Masahiro; Yamaguchi, Masao; Hoshino, Masahiro; Kanaji, Yoshihisa; Sugiyama, Tomoyo; Murai, Tadashi; Lee, Tetsumin; Yonetsu, Taishi; Kakuta, Tsunekazu; Kunio, Mie; Tearney, Guillermo J; Maehara, Akiko.
Afiliación
  • Usui E; Clinical Trials Center, Cardiovascular Research Foundation, New York, USA; NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, USA.
  • Matsumura M; Clinical Trials Center, Cardiovascular Research Foundation, New York, USA.
  • Mintz GS; Clinical Trials Center, Cardiovascular Research Foundation, New York, USA.
  • Zhou Z; Clinical Trials Center, Cardiovascular Research Foundation, New York, USA.
  • Hada M; Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Ibaraki, Japan.
  • Yamaguchi M; Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Ibaraki, Japan.
  • Hoshino M; Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Ibaraki, Japan.
  • Kanaji Y; Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Ibaraki, Japan.
  • Sugiyama T; Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Ibaraki, Japan.
  • Murai T; Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Ibaraki, Japan.
  • Lee T; Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
  • Yonetsu T; Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
  • Kakuta T; Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Ibaraki, Japan.
  • Kunio M; Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Canon U.S.A., Inc., Cambridge, MA, USA.
  • Tearney GJ; Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • Maehara A; Clinical Trials Center, Cardiovascular Research Foundation, New York, USA; NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, USA. Electronic address: amaehara@crf.org.
Atherosclerosis ; 332: 41-47, 2021 09.
Article en En | MEDLINE | ID: mdl-34384955
BACKGROUND AND AIMS: Pathologists have shown that intraplaque hemorrhage contributes to plaque destabilization and is frequently co-located with cholesterol crystals (CC). Optical coherence tomography (OCT)-detected low-intensity area without attenuation (LIA) may represent intraplaque hemorrhage. We aimed to examine the prevalence and impact of OCT-detected LIA + CC in untreated non-culprit lesions (NCLs) on subsequent major adverse cardiac events (MACE). METHODS: OCT imaged NCLs in the culprit vessel in the patients who underwent OCT-guided percutaneous coronary intervention were included. An NCL was a lesion with >90° of diseased arc (≥0.5 mm intimal thickness), length ≥2 mm, and >5 mm away from stent edge. CC was defined as a thin linear region of high intensity. NCL-related MACE includes cardiac death, myocardial infarction, or ischemia-driven revascularization attributed to NCLs. RESULTS: We included 735 NCLs in 566 patients with 2.5 ± 0.7 years follow-up. The prevalence of concomitant LIA with CC (LIA + CC) was 15.5% (114/735). Three-year NCL-related MACE rate was 2.9% (20 events) at a lesion level and 15.6% (78 events) at a patient level. Untreated NCLs with LIA + CC had an increased risk for NCL-MACE (adjusted hazard ratio [HR] 3.09, 95% confidence interval [CI] 1.27-7.50, p = 0.01) along with thin-cap fibroatheroma (adjusted HR 4.38, 95% CI 1.44-13.30, p < 0.01) and minimum lumen area <3.5 mm2 (adjusted HR 5.33, 95% CI 1.94-14.62, p < 0.01). Patients having ≥1 untreated NCL with LIA + CC had an increased risk for NCL-MACE (adjusted HR 1.95, 95% CI 1.19-3.19, p < 0.01). CONCLUSIONS: An OCT-detected LIA + CC in an NCL was associated with subsequent NCL-MACE.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de la Arteria Coronaria / Tomografía de Coherencia Óptica Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Atherosclerosis Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Irlanda
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de la Arteria Coronaria / Tomografía de Coherencia Óptica Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Atherosclerosis Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Irlanda