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学科主题: 临床医学
题名:
Predictors of Plaque Rupture Within Nonculprit Fibroatheromas in Patients With Acute Coronary Syndromes The PROSPECT Study
作者: Zheng, Bo1,2,3; Mintz, Gary S.2; McPherson, John A.4; De Bruyne, Bernard5; Farhat, Naim Z.6; Mars, Steven P.7; Serruys, Patrick W.8; Stone, Gregg W.1,2; Maehara, Akiko1,2
关键词: fibroatheroma ; intravascular ultrasound ; plaque rupture
刊名: JACC-CARDIOVASCULAR IMAGING
发表日期: 2015-10-01
DOI: 10.1016/j.jcmg.2015.06.014
卷: 8, 期:10, 页:1180-1187
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Cardiac & Cardiovascular Systems ; Radiology, Nuclear Medicine & Medical Imaging
研究领域[WOS]: Cardiovascular System & Cardiology ; Radiology, Nuclear Medicine & Medical Imaging
关键词[WOS]: INTRAVASCULAR ULTRASOUND ANALYSIS ; ACUTE MYOCARDIAL-INFARCTION ; THIN-CAP FIBROATHEROMAS ; SHEAR-STRESS ; CULPRIT LESIONS ; FREQUENCY ; ARTERIES ; ATHEROSCLEROSIS ; BURDEN ; DEATH
英文摘要:

OBJECTIVES The study sought to examine the relative importance of lesion Location versus vessel area and plaque burden in predicting plaque rupture within nonculprit fibroatheromas (FAs) in patients with acute coronary syndromes.

BACKGROUND Previous studies have demonstrated that plaque rupture is associated with larger vessel area and greater plaque burden clustering in the proximal segments of coronary arteries.

METHODS In the PROSPECT (Providing Regional Observations to Study Predictors of Events in the Coronary Tree) study 3-vessel grayscale and radiofrequency-intravascular ultrasound was performed after successful percutaneous coronary intervention in 697 patients with acute coronary syndromes. Untreated nonculprit Lesion FAs were classified as proximal (<20 mm), mid (20 to 40 mm), and distal (>40 mm) according to the distance from the ostium to the maximum necrotic core site.

RESULTS Overall, 74 ruptured FAs and 2,396 nonruptured FAs were identified in nonculprit vessels. The majority of FAs (73.6%) were located within 40 mm of the ostium, and the vessel area and plaque burden progressively decreased from proximal to distal FA Location (both p < 0.001). In a multivariate logistic regression model, independent predictors for plaque rupture included the distance from the ostium to the maximum necrotic core site per millimeter (odds ratio [OR]: 0.86; 95% confidence interval [CI]: 0.76 to 0.98; p = 0.02), plaque burden per 10% (OR: 2.05; 95% CI: 1.63 to 2.58; p < 0.0001), vessel area per mm(2) (OR: 1.14; 95% CI: 1.11 to 1.17; p < 0.0001), calcium (OR: 0.09; 95% CI: 0.05 to 0.18; p < 0.0001), and right coronary artery Location (OR: 2.16; 95% CI: 1.25 to 3.27; p = 0.006). By receiver-operating characteristic analysis, vessel area correlated with plaque rupture stronger than either plaque burden (p < 0.001) or location (p < 0.001).

CONCLUSIONS Large vessel area, plaque burden, proximal Location, right coronary artery Location, and lack of calcium were associated with FA plaque rupture. The present study suggests that among these variables, vessel area may be the strongest predictor of plaque rupture among non-left main coronary arteries. (PROSPECT: An Imaging Study in Patients With Unstable Atherosclerotic Lesions [PROSPECT]; NCT00180466) (C) 2015 by the American College of Cardiology Foundation.

语种: 英语
项目资助者: Boston Scientific ; Volcano Corporation ; InfraReDx ; Cardiox, Inc. ; Healthwise, Inc. ; Velomedix Inc ; St. Jude Medical ; Bristol-Myers Squibb ; Nova Nordisk ; Terumo ; The Medicines Company
WOS记录号: WOS:000363096100011
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/65472
Appears in Collections:北京大学第一临床医学院_期刊论文

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作者单位: 1.New York Presbyterian Columbia Univ, Med Ctr, New York, NY USA
2.Cardiovasc Res Fdn, New York, NY USA
3.Peking Univ, Hosp 1, Beijing 100871, Peoples R China
4.Vanderbilt Univ, Sch Med, Nashville, TN 37212 USA
5.OLV Clin, Cardiovasc Ctr Aalst, Aalst, Belgium
6.Elyria Mem Hosp, Reg Med Ctr, North Ohio Heart Ctr, Elyria, OH USA
7.Erasmus MC, Rotterdam, Netherlands
8.Univ Texas SW Med Ctr Dallas, Dallas, TX 75390 USA

Recommended Citation:
Zheng, Bo,Mintz, Gary S.,McPherson, John A.,et al. Predictors of Plaque Rupture Within Nonculprit Fibroatheromas in Patients With Acute Coronary Syndromes The PROSPECT Study[J]. JACC-CARDIOVASCULAR IMAGING,2015,8(10):1180-1187.
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