Abstract 16604: Association Between Prior Aspirin Use and Optical Coherence Tomography Findings in Type II Diabetes Mellitus Patients Presenting With First Acute Coronary Events
Backgrounds: Aspirin has been used for the treatment of cardiovascular disease. However, it is less clear whether prior aspirin therapy affects first acute coronary syndromes (ACS) presentation and/or lesion morphology in ACS. We investigated the association between prior aspirin use and the culprit lesion morphology examined by optical coherence tomography (OCT) in patients with the first ACS event. We further performed the subgroup analysis on the basis of the presence or the absence of type 2 diabetes mellitus (DM).
Methods and Results: We studied 263 patients with the first ACS event who had identifiable 263 native de novo culprit lesions. All patients underwent OCT examinations before PCI. Clinical and OCT findings were compared between the two groups divided on the basis of prior aspirin use (ASA; n= 30: 11%, non-ASA; n = 233: 89%), and then, in diabetic (n=77, 29%) and non-diabetic patients (n=186, 71%) for the subset analysis. There were no significant differences in the clinical presentations between ASA and non-ASA groups. Frequency of coronary occlusion (TIMI 0-1) at initial angiogram was also similar in both groups (ASA: 27% vs. non-ASA: 24%, P = 0.82). In OCT analysis, the presence of thrombi (ASA: 37% vs. non-ASA: 70%, P < 0.01) was significantly less frequent in ASA group, whereas frequency of OCT-derived TCFA, plaque rupture, thinnest cap thickness, and lipid quadrants were not statistically significant between the two groups. For DM subgroup analysis, 7 (9%) and 70 (91%) patients with DM were ASA group and non-ASA group, respectively, whereas 23 (12%) patients were ASA group and 163 (88%) patients were non-ASA group in non-DM subgroup. In non-DM, presence of thrombi was significantly less observed in ASA group (ASA: 26% vs. non-ASA: 70%, P <0.01), whereas no significant difference in the frequency of the presence of thrombi was observed in non-DM subgroup analysis (ASA: 71% vs. non-ASA: 69%, P =1.00). No other differences in OCT findings were detected between diabetic and non-diabetic patients.
Conclusions: Prior aspirin use before the first ACS event was inversely associated with the frequency of OCT-derived thrombus detection in the culprit lesions, although this effect was observed only in non-diabetic patients.
- © 2013 by American Heart Association, Inc.