Abstract 5215: Plaque Color in the Culprit Lesion is Associated With Incidence of Revascularization After Percutaneous Coronary Intervention for Acute Myocardial Infarction
Purpose: Plaque color is reported to have close relationship with the plaque vulnerability and the onset of acute coronary syndrome (ACS). However, few data are available on the relationship between plaque color and clinical outcome after the onset of acute myocardial infarction (AMI). Therefore, we evaluated the relationship of in vivo plaque color by coronary angioscopy (CAS) with the long-term clinical outcome including revascularization in patients after percutaneous coronary intervention (PCI) for AMI.
Methods: Consecutive 230 patients with AMI were enrolled in the present study. The culprit lesions immediately before PCI were examined by CAS and were classified into three groups according to the color grade of the plaques: thick yellow plaque (TYP), yellow plaque (YP), or light yellow plaque (LYP).
Results: There were no differences in lipid profile and other coronary risk factors among the three groups. However, during the follow-up of 2 years, the incidence of major adverse cardiac event (MACE) was significantly less in patients with TYP than those with YP or LYP by Kaplan-Meier analysis (P=0.006), which was driven primarily by a decreased incidence of revacularization (P=0.018). Furthermore, TYP was an independent predictor for long-term MACE after adjustment of predictive factors (age, Killip class, multivessel coronary artery disease, ejection fraction and body mass index).
Conclusions: In AMI patients treated with PCI, the TYP in the culprit lesion independently predicted the long-term favorable prognosis, mainly due to less revascularization. This relationship might provide new insights for prevention of the secondary cardiac events after AMI.