Abstract 3780: Plaque Burden at the Left Main Coronary Artery Becomes a Predictor of Cardiovascular Events in Patients Who Underwent Percutaneous Coronary Interventions
Background: Relationship between plaque burden at the left main coronary artery (LMCA) measured by intravascular ultrasound (IVUS) and cardiovascular events has not been evaluated yet.
Methods: From April 2003 to December 2005, consecutive 227 patients with coronary artery disease were performed percutaneous coronary interventions (PCI) to the left anterior descending coronary artery or left circumflex coronary artery under the guidance of IVUS. Plaque burden at the LMCA lesions were calculated by IVUS during the PCI and we investigated relationship between plaque burden at the LMCA and major cardiac events (MACE) defined as cardiac death, non-fatal myocardial infarction, and revascularization including PCI and coronary artery bypass graft for de novo and/or restenosis lesions. Data were analyzed by grouping the patients into tertiles according to plaque burden; Tertile 1 (T1): <31.5%, Tertile 2 (T2): 31.5 to 44.6%, and Tertile 3 (T3): >44.6% area stenosis. The patients who underwent PCI to the LMCA were excluded in advance.
Results: The average of plaque burden was 38.1±13.6%. Until April 2006, 13.2% of T1, 22.4% of T2, and 49.3% of T3 experienced MACE. Upon Kaplan-Meier analysis, the proportion of MACE-free survival was significantly lower in T3 compared with T1 and T2 (p<0.0001, Figure⇓). Adjusted hazard ratios in T1 and T2, compared with patients in T3, were 0.22 [95%CI, 0.11 to 0.43, p<0.0001] and 0.37 [95%CI, 0.21 to 0.66, p=0.0008], respectively.
Conclusions: Plaque burden at the LMCA lesions may be useful as an indicator of coronary atherosclerosis and be a significant predictor of cardiovascular events.