Relationship between coronary plaque morphology of the left anterior descending artery and 12 months clinical outcome: The CLIMA study

CLIMA Investigators

Research output: Contribution to journalArticle

Abstract

Aims The CLIMA study, on the relationship between coronary plaque morphology of the left anterior descending artery and twelve months clinical outcome, was designed to explore the predictive value of multiple high-risk plaque features in the same coronary lesion [minimum lumen area (MLA), fibrous cap thickness (FCT), lipid arc circumferential extension, and presence of optical coherence tomography (OCT)-defined macrophages] as detected by OCT. Composite of cardiac death and target segment myocardial infarction was the primary clinical endpoint. Methods From January 2013 to December 2016, 1003 patients undergoing OCT evaluation of the untreated proximal left and results anterior descending coronary artery in the context of clinically indicated coronary angiogram were prospectively enrolled at 11 independent centres (clinicaltrial.gov identifier NCT02883088). At 1-year, the primary clinical endpoint was observed in 37 patients (3.7%). In a total of 1776 lipid plaques, presence of MLA <3.5 mm2 [hazard ratio (HR) 2.1, 95% confidence interval (CI) 1.1-4.0], FCT <75 mm (HR 4.7, 95% CI 2.4-9.0), lipid arc circumferential extension >180 (HR 2.4, 95% CI 1.2-4.8), and OCT-defined macrophages (HR 2.7, 95% CI 1.2-6.1) were all associated with increased risk of the primary endpoint. The pre-specified combination of plaque features (simultaneous presence of the four OCT criteria in the same plaque) was observed in 18.9% of patients experiencing the primary endpoint and was an independent predictor of events (HR 7.54, 95% CI 3.1-18.6). Conclusion The simultaneous presence of four high-risk OCT plaque features was found to be associated with a higher risk of major coronary events.

Original languageEnglish
Pages (from-to)383-391
Number of pages9
JournalEuropean heart journal
Volume41
Issue number3
DOIs
Publication statusPublished - 14-01-2020

Fingerprint

Optical Coherence Tomography
Arteries
Macrophages
Lipids
Coronary Vessels
Angiography
Myocardial Infarction

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

@article{de61572480e84ebc85c4fab623554bdd,
title = "Relationship between coronary plaque morphology of the left anterior descending artery and 12 months clinical outcome: The CLIMA study",
abstract = "Aims The CLIMA study, on the relationship between coronary plaque morphology of the left anterior descending artery and twelve months clinical outcome, was designed to explore the predictive value of multiple high-risk plaque features in the same coronary lesion [minimum lumen area (MLA), fibrous cap thickness (FCT), lipid arc circumferential extension, and presence of optical coherence tomography (OCT)-defined macrophages] as detected by OCT. Composite of cardiac death and target segment myocardial infarction was the primary clinical endpoint. Methods From January 2013 to December 2016, 1003 patients undergoing OCT evaluation of the untreated proximal left and results anterior descending coronary artery in the context of clinically indicated coronary angiogram were prospectively enrolled at 11 independent centres (clinicaltrial.gov identifier NCT02883088). At 1-year, the primary clinical endpoint was observed in 37 patients (3.7{\%}). In a total of 1776 lipid plaques, presence of MLA <3.5 mm2 [hazard ratio (HR) 2.1, 95{\%} confidence interval (CI) 1.1-4.0], FCT <75 mm (HR 4.7, 95{\%} CI 2.4-9.0), lipid arc circumferential extension >180 (HR 2.4, 95{\%} CI 1.2-4.8), and OCT-defined macrophages (HR 2.7, 95{\%} CI 1.2-6.1) were all associated with increased risk of the primary endpoint. The pre-specified combination of plaque features (simultaneous presence of the four OCT criteria in the same plaque) was observed in 18.9{\%} of patients experiencing the primary endpoint and was an independent predictor of events (HR 7.54, 95{\%} CI 3.1-18.6). Conclusion The simultaneous presence of four high-risk OCT plaque features was found to be associated with a higher risk of major coronary events.",
author = "{CLIMA Investigators} and Francesco Prati and Enrico Romagnoli and Laura Gatto and Manna, {Alessio La} and Francesco Burzotta and Yukio Ozaki and Valeria Marco and Alberto Boi and Massimo Fineschi and Franco Fabbiocchi and Nevio Taglieri and Giampaolo Niccoli and Carlo Trani and Francesco Versaci and Giuseppe Calligaris and Gianni Ruscica and {Di Giorgio}, Alessandro and Rocco Vergallo and Mario Albertucci and Giuseppe Biondi-Zoccai and Corrado Tamburino and Filippo Crea and Fernando Alfonso and Eloisa Arbustini",
year = "2020",
month = "1",
day = "14",
doi = "10.1093/eurheartj/ehz520",
language = "English",
volume = "41",
pages = "383--391",
journal = "European Heart Journal",
issn = "0195-668X",
publisher = "Oxford University Press",
number = "3",

}

Relationship between coronary plaque morphology of the left anterior descending artery and 12 months clinical outcome : The CLIMA study. / CLIMA Investigators.

In: European heart journal, Vol. 41, No. 3, 14.01.2020, p. 383-391.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Relationship between coronary plaque morphology of the left anterior descending artery and 12 months clinical outcome

T2 - The CLIMA study

AU - CLIMA Investigators

AU - Prati, Francesco

AU - Romagnoli, Enrico

AU - Gatto, Laura

AU - Manna, Alessio La

AU - Burzotta, Francesco

AU - Ozaki, Yukio

AU - Marco, Valeria

AU - Boi, Alberto

AU - Fineschi, Massimo

AU - Fabbiocchi, Franco

AU - Taglieri, Nevio

AU - Niccoli, Giampaolo

AU - Trani, Carlo

AU - Versaci, Francesco

AU - Calligaris, Giuseppe

AU - Ruscica, Gianni

AU - Di Giorgio, Alessandro

AU - Vergallo, Rocco

AU - Albertucci, Mario

AU - Biondi-Zoccai, Giuseppe

AU - Tamburino, Corrado

AU - Crea, Filippo

AU - Alfonso, Fernando

AU - Arbustini, Eloisa

PY - 2020/1/14

Y1 - 2020/1/14

N2 - Aims The CLIMA study, on the relationship between coronary plaque morphology of the left anterior descending artery and twelve months clinical outcome, was designed to explore the predictive value of multiple high-risk plaque features in the same coronary lesion [minimum lumen area (MLA), fibrous cap thickness (FCT), lipid arc circumferential extension, and presence of optical coherence tomography (OCT)-defined macrophages] as detected by OCT. Composite of cardiac death and target segment myocardial infarction was the primary clinical endpoint. Methods From January 2013 to December 2016, 1003 patients undergoing OCT evaluation of the untreated proximal left and results anterior descending coronary artery in the context of clinically indicated coronary angiogram were prospectively enrolled at 11 independent centres (clinicaltrial.gov identifier NCT02883088). At 1-year, the primary clinical endpoint was observed in 37 patients (3.7%). In a total of 1776 lipid plaques, presence of MLA <3.5 mm2 [hazard ratio (HR) 2.1, 95% confidence interval (CI) 1.1-4.0], FCT <75 mm (HR 4.7, 95% CI 2.4-9.0), lipid arc circumferential extension >180 (HR 2.4, 95% CI 1.2-4.8), and OCT-defined macrophages (HR 2.7, 95% CI 1.2-6.1) were all associated with increased risk of the primary endpoint. The pre-specified combination of plaque features (simultaneous presence of the four OCT criteria in the same plaque) was observed in 18.9% of patients experiencing the primary endpoint and was an independent predictor of events (HR 7.54, 95% CI 3.1-18.6). Conclusion The simultaneous presence of four high-risk OCT plaque features was found to be associated with a higher risk of major coronary events.

AB - Aims The CLIMA study, on the relationship between coronary plaque morphology of the left anterior descending artery and twelve months clinical outcome, was designed to explore the predictive value of multiple high-risk plaque features in the same coronary lesion [minimum lumen area (MLA), fibrous cap thickness (FCT), lipid arc circumferential extension, and presence of optical coherence tomography (OCT)-defined macrophages] as detected by OCT. Composite of cardiac death and target segment myocardial infarction was the primary clinical endpoint. Methods From January 2013 to December 2016, 1003 patients undergoing OCT evaluation of the untreated proximal left and results anterior descending coronary artery in the context of clinically indicated coronary angiogram were prospectively enrolled at 11 independent centres (clinicaltrial.gov identifier NCT02883088). At 1-year, the primary clinical endpoint was observed in 37 patients (3.7%). In a total of 1776 lipid plaques, presence of MLA <3.5 mm2 [hazard ratio (HR) 2.1, 95% confidence interval (CI) 1.1-4.0], FCT <75 mm (HR 4.7, 95% CI 2.4-9.0), lipid arc circumferential extension >180 (HR 2.4, 95% CI 1.2-4.8), and OCT-defined macrophages (HR 2.7, 95% CI 1.2-6.1) were all associated with increased risk of the primary endpoint. The pre-specified combination of plaque features (simultaneous presence of the four OCT criteria in the same plaque) was observed in 18.9% of patients experiencing the primary endpoint and was an independent predictor of events (HR 7.54, 95% CI 3.1-18.6). Conclusion The simultaneous presence of four high-risk OCT plaque features was found to be associated with a higher risk of major coronary events.

UR - http://www.scopus.com/inward/record.url?scp=85077943203&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85077943203&partnerID=8YFLogxK

U2 - 10.1093/eurheartj/ehz520

DO - 10.1093/eurheartj/ehz520

M3 - Article

C2 - 31504405

AN - SCOPUS:85077943203

VL - 41

SP - 383

EP - 391

JO - European Heart Journal

JF - European Heart Journal

SN - 0195-668X

IS - 3

ER -