Abstract 9661: Differences in Pathophysiology of Plaques Between Target Lesion and Non-Target Lesion Events After Successful Percutanous Cornary Intervention: Insights from Integrated Backscatter Intravascular Ultrasound
Objectives: We sought to determine the morphologic predictors of major adverse cardiac events (MACEs) after perctaneous coronary intervention (PCI), using integrated backscatter intravascular ultrasound (IB-IVUS).
Methods: Conventional and IB-IVUS using 40-MHz (motorized pullback 0.5mm/s) intravascular catheter were performed in 295 consecutive patients indicated for PCI. Three-dimensional analyses were performed to determine the total plaque volume and the volume of each plaque component (lipid, fibrous, and calcified). MACEs were defined as death, nonfatal myocardial infarction, heart failure required hospitalization, any repeat revascularization for the index target lesion (TLR), and non-target ischemic events. Non-target ischemic events were defined as nonfatal myocardial infarction, any repeat revascularization for angina involving the non-target vessel or the target vessel outside the index lesion.
Results: The median follow-up interval was 982 days. During the follow-up period, MACEs were observed in 78 (26.4%) patients including TLR in 40 (13.6%) and non-target ischemic events in 31 (10.5%). With the Cox proportional hazard model after adjustment for confounders, MACEs were associated with chronic kidney disease (OR 2.26, 95% CI 1.25-4.08, p=0.007) and diabetes (OR 1.75, 95% CI 1.06-2.89, p=0.03). But as for each components, TLR were significantly associated with percentage of plaque volume (OR 1.06, 95% CI 1.01-1.10, p=0.04), and non-target lesion ischemic events were significantly associated with percentage of lipid volume (OR 1.03, 95% CI 1.00-1.06, p=0.03).
Conclusions: Greater plaque burdens were significantly associated with TLR, while lipid-rich contents were relevant to non-target lesion events. These findings may have implications regarding the differences in pathophysiology of plaques between the TLR and non-target lesion events.
- Intravascular ultrasound/Doppler
- Acute coronary syndromes
- Coronary artery disease
- Percutaneous coronary intervention
- © 2011 by American Heart Association, Inc.