Abstract 20597: Phenotype of Culprit Plaque Calcification Differs between Elderly and Young Patients with ST-segment Elevation Myocardial Infarction -Morphological Analysis by Virtual Histology-Intravascular Ultrasound-
Objectives: It is well known calcium deposition of atherosclerotic plaque is associated with plaque vulnerability and pathogenesis of acute coronary syndrome. Recent studies have shown coronary calcification in patients dying with severe coronary disease increases as age progression. However, data on age differences of calcium deposits at the culprit lesion in patients with ST-segment elevation myocardial infarction (STEMI) is lacking. We aimed to assess the differences of calcification patterns at the culprit lesion between elderly and young patients with STEMI by virtual histology-intravascular ultrasound (VH-IVUS).
Methods and Results: Consecutive 101 patients with de novo STEMI treated with primary PCI were enrolled. We performed VH-IVUS following thrombus aspiration. Patients were divided into two groups according to age: Young group (Y-group: < 75 years of age) and Elderly group (E-group: ≥75 years of age). We evaluate the difference of plaque phenotype and pattern of calcium deposition at the culprit lesion by VH-IVUS. The higher frequencies of hypertension, chronic kidney disease were observed in E-group. The percentage of dense calcium was significantly higher in E-group and increased as age progression. The incidence of mild calcification, so called spotty calcification, was significantly higher in Y-group than in E-group. The other hands, the incidence of severe calcification was significantly higher in E-group. Especially, high incidence of severe calcification was observed in patients over 75 years of age. The distribution of calcium deposition in E-group was more superficial than in Y-group.
Conclusions: The culprit lesions of elderly STEMI patients have larger and severe calcium burden than the young STEMI patients, and calcium deposits increases as age progression. Our data suggest that coronary calcification associated with aging may contribute to pathogenetic mechanism and poor prognosis observed in elderly patients with STEMI.
- © 2010 by American Heart Association, Inc.