Predictors of Coronary Plaque Erosion in Current and Non-Current Smokers With ST-Segment Elevation Myocardial Infarctionã- An Optical Coherence Tomography Study.
Circ J
; 85(10): 1814-1822, 2021 09 24.
Article
em En
| MEDLINE
| ID: mdl-33504712
ABSTRACT
BACKGROUND:
Smoking is an important risk factor of plaque erosion. This study aimed to investigate the predictors of plaque erosion in current and non-current smokers presenting with ST-segment elevation myocardial infarction (STEMI).MethodsâandâResults:
A total of 1,320 STEMI patients with culprit plaque rupture or plaque erosion detected by pre-intervention optical coherence tomography were divided into a current smoking group (n=715) and non-current smoking group (n=605). Plaque erosion accounted for 30.8% (220/715) of culprit lesions in the current smokers and 21.2% (128/605) in the non-current smokers. Multivariable analysis showed age <50 years, single-vessel disease and the absence of dyslipidemia were independently associated with plaque erosion rather than plaque rupture, regardless of smoking status. In current smokers, diabetes mellitus (odds ratio [OR] 0.29; 95% confidence interval [CI] 0.10-0.83; P=0.021) was negatively associated with plaque erosion as compared with plaque rupture. In non-current smokers, minimal lumen area (MLA, OR 1.37; 95% CI 1.16-1.62; P<0.001) and nearby bifurcation (OR 3.20; 95% CI 1.98-5.16; P<0.001) were positively related to plaque erosion, but not plaque rupture.CONCLUSIONS:
In patients with STEMI, the presence of diabetes mellitus significantly increased the risk of rupture-based STEMI but may not have reduced the risk of plaque erosion-based STEMI in current smokers. Nearby bifurcation and larger MLA were associated with plaque erosion in non-current smokers.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Placa Aterosclerótica
/
Intervenção Coronária Percutânea
/
Infarto do Miocárdio com Supradesnível do Segmento ST
Tipo de estudo:
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
/
Middle aged
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article