Lipid-rich plaques predict non-target-lesion ischemic events in patients undergoing percutaneous coronary intervention-insights from integrated backscatter intravascular ultrasound

Tetsuya Amano, Tatsuaki Matsubara, Tadayuki Uetani, Masataka Kato, Bunichi Kato, Tomohiro Yoshida, Ken Harada, Soichiro Kumagai, Ayako Kunimura, Yusaku Shinbo, Hideki Ishii, Toyoaki Murohara

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Despite growing interest in non-target lesion events in patients undergoing percutaneous coronary intervention (PCI), there has been little discussion of predictors. Methods and Results: A total of 155 consecutive patients who underwent PCI were enrolled. Conventional and integrated backscatter intravascular ultrasound (IB-IVUS) parameters were measured in non-target lesions utilizing a 40-MHz intravascular catheter. Lipid-rich plaques (LRP) were defined as lesions with an increased lipid volume (>median) and greater lipid content. Non-target ischemic events were defined as death, non-fatal myocardial infarction, any repeat revascularization and rehospitalization for angina involving the non-target vessel or the target vessel outside the index lesion. During the follow-up period (median: 1,265 days), non-target events were observed in 16 patients (11%). Using the Cox proportional hazard model, LRP (odds ratio [OR], 6.06; 95% confidence interval [CI]: 1.81-20.4, P=0.0035), elevated serum C-reactive protein (CRP) levels (OR, 6.83; 95%CI: 2.19-21.3, P=0.0009) and acute coronary syndrome present at baseline (OR, 4.08; 95%CI: 1.21-13.8, P=0.024) were significantly and independently associated with non-target events. Synergistic effects of LRP and elevated serum CRP levels for prediction of non-target events (OR, 14.8; 95%CI: 4.57-48.0, P<0.0001) were found even after adjusting for confounders. Conclusions: LRP measured using IB-IVUS proved to be an independent morphologic predictor of non-target ischemic events after PCI, particularly enhancing the risk in patients with elevated serum CRP levels.

Original languageEnglish
Pages (from-to)158-166
Number of pages9
JournalCirculation Journal
Volume75
Issue number1
DOIs
Publication statusPublished - 2011

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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