Abstract 11830: Clinical Impact of Integrated Backscatter Intravascular Ultrasound Analysis for Predicting Major Adverse Cardiac Events After Primary Percutaneous Coronary Intervention in Patients With Acute Coronary Syndrome
Background and Aims Plaque color assessed by coronary angioscope (CA) was associated with long-term clinical outcomes in patients with acute myocardial infarction undergoing percutaneous coronary intervention (PCI). Integrated backscatter intravascular ultrasound (IB-IVUS) is considered to be a more precise tool for visualizing tissue characterization of coronary plaque than CA. Furthermore IB-IVUS is more safety tool than CA, since it needs no balloon occlusion to get clear visible [[Unable to Display Character: ﬁ]]eld. The aim of this study was to investigate the relationship between plaque components analyzed by IB-IVUS and major adverse cardiac events (MACE) after PCI.
Method and Results The 115 consecutive acute coronary syndrome (ACS) patients (mean age 67 + 12 years old) who received primary PCI using IB-IVUS were enrolled. There were 65 patients with ST-segment elevation myocardial infarction (STEMI), 19 non-STEMI and 31 unstable angina pectoris patients. During a mean follow-up period of 330 days, total 19 MACE (3 cardiac deaths, 1 myocardial infarction, 3 stent thrombosis, 6 worsening of heart failures and 6 revascularizations for new coronary lesion) was observed. Lipid volume (LPV) and percentage of lipid volume (%LPV) were significantly larger in patients with MACE. A receiver operating characteristic analysisdetermined the cut-off values for prediction of MACE as 102mm3 in LPV and 58% in %LPV. Multivariate Cox regression analysis showed that high %LPV (> 58%) was an independent prognostic factor for MACE (odds ratio: 8.31, 95% CI 1.61 to 53.6, p = 0.011). Kaplan-Meier analysis showed that patients with low LPV (> 102 mm3) were more likely to be free of MACE than those with high LPV (> 102 mm3). In addition, patients with low %LPV (> 58%) were more likely to be free of MACE than those with high %LPV (> 58%).
Conclusion Plaque analysis by using IB-IVUS is useful to stratify high risk ACS patients with MACE after PCI. %LPV measured by IB-IVUS could be one of valuable predictors for MACE after PCI.
- © 2012 by American Heart Association, Inc.