Incidence, factors, and clinical significance of cholesterol crystals in coronary plaque: An optical coherence tomography study.
Atherosclerosis
; 283: 79-84, 2019 04.
Article
in En
| MEDLINE
| ID: mdl-30802681
ABSTRACT
BACKGROUND AND AIMS:
Intraplaque cholesterol crystal (CC) is recognized as a component of vulnerable plaques. However, the clinical characteristics of patients with CC and the impact of CC on clinical events remain unknown.METHODS:
A total of 340 consecutive patients who underwent optical coherence tomography (OCT) imaging of culprit lesions were included in the study. CC was defined as a thin linear structure with high reflectivity and low signal attenuation on OCT images. The incidence of major adverse cardiovascular events (MACE) at 1-year was compared between patients with CC (CC group) and those without CC (non-CC group). MACE included cardiac death, non-fatal myocardial infarction, target vessel revascularization (TVR), and non-TVR (NTVR).RESULTS:
CC was observed in 29% (nâ¯=â¯98) of the patients. There was no significant difference in baseline clinical characteristics between the CC and non-CC groups, other than in eicosapentaenoic acid (EPA)/arachidonic acid (AA) ratio (0.39⯱â¯0.29 vs. 0.47⯱â¯0.33, pâ¯=â¯0.047) and hemoglobin A1c (HbA1c) levels (6.51⯱â¯0.97 vs. 6.25⯱â¯0.87%, pâ¯=â¯0.016). The incidence of MACE and NTVR at 1-year was significantly higher in the CC group than in the non-CC group (15.3 vs. 7.9%, Pâ¯=â¯0.038; 8.1 vs. 2.5%, pâ¯=â¯0.017). The presence of CC was significantly associated with a higher rate of 1-year MACE (odds ratio 4.78, confidential interval 2.02-10.10, pâ¯<â¯0.001).CONCLUSIONS:
Patients with CC in the culprit lesion had higher HbA1c and lower EPA/AA than patients without CC. The 1-year clinical outcomes in patients with CC in the culprit lesion were worse than in those without CC.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Coronary Artery Disease
/
Cholesterol
/
Coronary Vessels
/
Tomography, Optical Coherence
/
Plaque, Atherosclerotic
Type of study:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Aged
/
Female
/
Humans
/
Male
Country/Region as subject:
Asia
Language:
En
Journal:
Atherosclerosis
Year:
2019
Document type:
Article
Affiliation country:
Japan