Lipid-rich large plaques in a non-culprit left main coronary artery and long-term clinical outcomes

Hiroshi Tashiro, Akihito Tanaka, Hideki Ishii, Keisuke Sakakibara, Akihiro Tobe, Takashi Kataoka, Yusuke Miki, Yusuke Hitora, Kiyoshi Niwa, Kenji Furusawa, Toyoaki Murohara

Research output: Contribution to journalArticle

Abstract

Background: An integrated backscatter (IB) intravascular ultrasound (IVUS) provides an information about tissue components and vulnerability of coronary plaques. The presence of vulnerable plaque in non-culprit lesion is associated with future clinical events. The purpose of this study was to assess the association between the characteristics of non-culprit left main coronary artery (LMCA) plaques evaluated by IB-IVUS and long-term clinical outcomes in patients undergoing percutaneous coronary intervention (PCI). Methods: Among the patients who underwent non-LMCA PCI, we studied 366 patients with adequate LMCA IVUS images. Conventional and IB-IVUS analyses of the LMCA segment were performed. Lipid-rich large plaque was defined as the presence of both a lager plaque volume and a higher percentage of the lipid component than the obtained median values. Major adverse cardiovascular events (MACE) included cardiac death, myocardial infarction, and unplanned revascularization. Results: The mean age of the patients was 68.5 ± 10.2 years, 79.8% were men. Median follow-up period was 6.0 years (IQR: 4.2–8.1 years). The incidence of MACE was significantly higher in patients with lipid-rich large plaques (P = .006). The incidence rates of cardiac death, myocardial infarction, and unplanned revascularization were significantly higher in patients with lipid-rich large plaques (P = .02, 0.004, and 0.02, respectively). Multivariate Cox regression analysis showed that the presence of a lipid-rich large plaque was significantly associated with MACE (HR: 1.74; 95%CI: 1.17–2.58; P = .006). Conclusion: The presence of lipid-rich large plaques in a non-culprit LMCA can be associated with the long-term MACE in patients who have undergone PCI.

Original languageEnglish
Pages (from-to)5-10
Number of pages6
JournalInternational Journal of Cardiology
Volume305
DOIs
Publication statusPublished - 15-04-2020

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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    Tashiro, H., Tanaka, A., Ishii, H., Sakakibara, K., Tobe, A., Kataoka, T., Miki, Y., Hitora, Y., Niwa, K., Furusawa, K., & Murohara, T. (2020). Lipid-rich large plaques in a non-culprit left main coronary artery and long-term clinical outcomes. International Journal of Cardiology, 305, 5-10. https://doi.org/10.1016/j.ijcard.2020.01.072