Abstract 2127: Incidence, Predictors And Prognostic Implication Of Plaque Rupture In Peripheral Artery: An Intravascular Ultrasound Study
Background: Intravascular ultrasound (IVUS) studies have shown that coronary plaque rupture (PR) can be observed in patients with acute coronary syndrome as well as stable angina pectoris. Incidence and clinical significance of the peripheral arterial PR have not been well investigated.
Objectives: The aim of this study was to clarify incidence, predictors and prognostic implication of PR in peripheral artery in patients with peripheral arterial disease (PAD).
Methods: Fifty peripheral (iliac and femoral) arteries from 50 patients undergoing percutanoues transluminal angioplasty were included and studied. IVUS imaging was performed before angioplasty. PR was defined as presence of a cavity that communicated with the lumen with an overlying residual fibrous cap fragment.
Results: PR was found in 18 of 50 arteries (36 %), 13 single and 5 multiple ruptures. Clinical characteristics did not differ between patients with and without PR except for a higher incidence of prior history of acute coronary syndrome observed in patients with PR as compared with patients without PR (56% vs. 25%, p=0.03). Patients with PR had significantly higher incidence of cardiovascular events (death, myocardial infarction, revascularization, hemodialysis and ischemic stroke) than those without (28 % vs. 9 %, p=0.04). Cardiovascular events-free survival was significantly lower in patients with PR than in patients without PR (Log-rank, p=0.04).(Figure⇓)
Conclusions: Ruptured plaque of the peripheral artery may be associated with history of acute coronary syndrome, suggesting the presence of pan-arterial vulnerability. In addition, patients with PR may have worse clinical outcome.