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Prognostic Value of Intravascular Ultrasound in Patients With Coronary Artery Disease.
Schuurman, Anne-Sophie; Vroegindewey, Maxime M; Kardys, Isabella; Oemrawsingh, Rohit M; Garcia-Garcia, Hector M; van Geuns, Robert-Jan; Regar, Evelyn; Van Mieghem, Nicolas M; Ligthart, Jurgen; Serruys, Patrick W; Boersma, Eric; Akkerhuis, K Martijn.
Afiliação
  • Schuurman AS; Department of Cardiology, Erasmus Medical Center, University Medical Center, Rotterdam, the Netherlands; Cardiovascular Research School COEUR, Erasmus MC University Medical Center, Rotterdam, the Netherlands.
  • Vroegindewey MM; Department of Cardiology, Erasmus Medical Center, University Medical Center, Rotterdam, the Netherlands; Cardiovascular Research School COEUR, Erasmus MC University Medical Center, Rotterdam, the Netherlands.
  • Kardys I; Department of Cardiology, Erasmus Medical Center, University Medical Center, Rotterdam, the Netherlands; Cardiovascular Research School COEUR, Erasmus MC University Medical Center, Rotterdam, the Netherlands.
  • Oemrawsingh RM; Department of Cardiology, Erasmus Medical Center, University Medical Center, Rotterdam, the Netherlands; Cardiovascular Research School COEUR, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Cardiology, Amphia Hospital, Breda, the Netherlands.
  • Garcia-Garcia HM; Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC.
  • van Geuns RJ; Department of Cardiology, Erasmus Medical Center, University Medical Center, Rotterdam, the Netherlands; Cardiovascular Research School COEUR, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands.
  • Regar E; Department of Cardiology, Erasmus Medical Center, University Medical Center, Rotterdam, the Netherlands; Cardiovascular Research School COEUR, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Cardiovascular Surgery, University Hospital Zurich, Zurich, Switzerland.
  • Van Mieghem NM; Department of Cardiology, Erasmus Medical Center, University Medical Center, Rotterdam, the Netherlands; Cardiovascular Research School COEUR, Erasmus MC University Medical Center, Rotterdam, the Netherlands.
  • Ligthart J; Department of Cardiology, Erasmus Medical Center, University Medical Center, Rotterdam, the Netherlands.
  • Serruys PW; Department of Cardiology, Erasmus Medical Center, University Medical Center, Rotterdam, the Netherlands; Imperial College, London, United Kingdom.
  • Boersma E; Department of Cardiology, Erasmus Medical Center, University Medical Center, Rotterdam, the Netherlands; Cardiovascular Research School COEUR, Erasmus MC University Medical Center, Rotterdam, the Netherlands.
  • Akkerhuis KM; Department of Cardiology, Erasmus Medical Center, University Medical Center, Rotterdam, the Netherlands; Cardiovascular Research School COEUR, Erasmus MC University Medical Center, Rotterdam, the Netherlands. Electronic address: k.m.akkerhuis@erasmusmc.nl.
J Am Coll Cardiol ; 72(17): 2003-2011, 2018 10 23.
Article em En | MEDLINE | ID: mdl-30336823
BACKGROUND: It has been shown that intravascular ultrasound (IVUS) and radiofrequency (RF-)IVUS can detect high-risk coronary plaque characteristics. OBJECTIVES: The authors studied the long-term prognostic value of (RF-)IVUS-derived plaque characteristics in patients with coronary artery disease (CAD) undergoing coronary angiography. METHODS: From 2008 to 2011, (RF-)IVUS was performed in 1 nonstenotic segment of a nonculprit coronary artery in 581 patients undergoing coronary angiography for acute coronary syndrome (ACS) or stable angina. The pre-defined primary endpoint was major adverse cardiovascular events (MACE), defined as the composite of all-cause death, nonfatal ACS, or unplanned revascularization. Hazard ratios (HRs) were adjusted for age, sex, and clinical risk factors. RESULTS: During a median follow-up of 4.7 years, 152 patients (26.2%) had MACE. The presence of a lesion with a minimal luminal area ≤4.0 mm2 was independently associated with MACE (HR: 1.49; 95% CI: 1.07 to 2.08; p = 0.020), whereas the presence of a thin-cap fibroatheroma lesion or a lesion with a plaque burden ≥70% on its own were not. Results were comparable when the composite endpoint included cardiac death instead of all-cause death. The presence of a lesion with a plaque burden of ≥70% was independently associated with the composite endpoint of cardiac death, nonfatal ACS, or unplanned revascularization after exclusion of culprit lesion-related events (HR: 1.66; 95% CI: 1.06 to 2.58; p = 0.026). Likewise, each 10-U increase in segmental plaque burden was independently associated with a 26% increase in risk of this composite endpoint (HR: 1.26 per 10-U increase; 95% CI: 1.03 to 1.52; p = 0.022). CONCLUSIONS: IVUS-derived small luminal area and large plaque burden, and not RF-IVUS-derived compositional plaque features on their own, predict adverse cardiovascular outcome during long-term follow-up in patients with CAD. (The European Collaborative Project on Inflammation and Vascular Wall Remodeling in Atherosclerosis-Intravascular Ultrasound Study [AtheroRemoIVUS]; NCT01789411).
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Doença da Artéria Coronariana / Ultrassonografia de Intervenção / Vasos Coronários / Morte / Placa Aterosclerótica / Efeitos Adversos de Longa Duração Tipo de estudo: Diagnostic_studies / Etiology_studies / Prognostic_studies Limite: Aged / Female / Humans / Male / Middle aged País como assunto: Europa Idioma: En Ano de publicação: 2018 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Doença da Artéria Coronariana / Ultrassonografia de Intervenção / Vasos Coronários / Morte / Placa Aterosclerótica / Efeitos Adversos de Longa Duração Tipo de estudo: Diagnostic_studies / Etiology_studies / Prognostic_studies Limite: Aged / Female / Humans / Male / Middle aged País como assunto: Europa Idioma: En Ano de publicação: 2018 Tipo de documento: Article