Lipid-rich plaques predict non-target-lesion ischemic events in patients undergoing percutaneous coronary intervention.
Circ J
; 75(1): 157-66, 2011.
Article
em En
| MEDLINE
| ID: mdl-21116071
ABSTRACT
BACKGROUND:
Despite growing interest in non-target lesion events in patients undergoing percutaneous coronary intervention (PCI), there has been little discussion of predictors. METHODS ANDRESULTS:
A total of 155 consecutive patients who underwent PCI were enrolled. Conventional and integrated backscatter intravascular ultrasound (IB-IVUS) parameters were measured in non-target lesions utilizing a 40-MHz intravascular catheter. Lipid-rich plaques (LRP) were defined as lesions with an increased lipid volume (> median) and greater lipid content. Non-target ischemic events were defined as death, non-fatal myocardial infarction, any repeat revascularization and rehospitalization for angina involving the non-target vessel or the target vessel outside the index lesion. During the follow-up period (median 1,265 days), non-target events were observed in 16 patients (11%). Using the Cox proportional hazard model, LRP (odds ratio [OR], 6.06; 95% confidence interval [CI] 1.81-20.4, P = 0.0035), elevated serum C-reactive protein (CRP) levels (OR, 6.83; 95%CI 2.19-21.3, P = 0.0009) and acute coronary syndrome present at baseline (OR, 4.08; 95%CI 1.21-13.8, P = 0.024) were significantly and independently associated with non-target events. Synergistic effects of LRP and elevated serum CRP levels for prediction of non-target events (OR, 14.8; 95%CI 4.57-48.0, P < 0.0001) were found even after adjusting for confounders.CONCLUSIONS:
LRP measured using IB-IVUS proved to be an independent morphologic predictor of non-target ischemic events after PCI, particularly enhancing the risk in patients with elevated serum CRP levels.
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Base de dados:
MEDLINE
Assunto principal:
Angioplastia Coronária com Balão
/
Isquemia Miocárdica
/
Ultrassonografia de Intervenção
/
Síndrome Coronariana Aguda
/
Angina Pectoris
/
Lipídeos
Tipo de estudo:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Asia
Idioma:
En
Revista:
Circ J
Assunto da revista:
ANGIOLOGIA
/
CARDIOLOGIA
Ano de publicação:
2011
Tipo de documento:
Article
País de afiliação:
Japão