Clinical significance of the presence of puff-chandelier ruptures detected by nonobstructive aortic angioscopy.
Aged
Angioscopy
Aorta
/ pathology
Aortic Diseases
/ mortality
Atherosclerosis
/ mortality
Coronary Artery Disease
/ diagnostic imaging
Databases, Factual
Female
Humans
Japan
/ epidemiology
Male
Middle Aged
Percutaneous Coronary Intervention
/ adverse effects
Plaque, Atherosclerotic
Predictive Value of Tests
Prevalence
Retrospective Studies
Risk Assessment
Risk Factors
Rupture, Spontaneous
Treatment Outcome
atherosclerotic aortic plaques
nonobstructive angioscopy
percutaneous coronary intervention
Journal
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
ISSN: 1522-726X
Titre abrégé: Catheter Cardiovasc Interv
Pays: United States
ID NLM: 100884139
Informations de publication
Date de publication:
01 10 2020
01 10 2020
Historique:
received:
29
05
2019
revised:
13
09
2019
accepted:
25
10
2019
pubmed:
11
11
2019
medline:
8
6
2021
entrez:
10
11
2019
Statut:
ppublish
Résumé
This study aimed to investigate the prevalence and prognostic significance of atherosclerotic aortic plaques (AAPs) or specific AAP types detected by nonobstructive angioscopy (NOA) in patients who underwent percutaneous coronary intervention (PCI). Although recent studies have reported the presence of various patterns of AAPs, identified by NOA, the clinical significance of the presence of AAPs remains elusive. In this retrospective, multicenter cohort study, a total of 167 patients who underwent PCI and intra-aortic scans with NOA were studied. The association between AAPs and the incidence of major adverse cardiac events (MACEs), including cardiac death, myocardial infarction, stroke, and clinically driven unplanned revascularizations, was assessed. AAPs were detected in 126 patients (75%) who underwent NOA. MACEs occurred in 28 (17%) patients during the follow-up (median 2.9 years [range 2.1-3.8]). Among all types of AAPs, only puff-chandelier rupture (PCR) showed a significant difference in frequency between patients with and those without MACEs: 21 (75%) and 49 (35%), respectively (p < .001). Multivariable Cox proportional hazard analysis revealed that PCR (hazard ratio [HR] 3.73, 95% confidence interval [CI] 1.57-8.87, p = .004) and chronic kidney disease (HR 2.97, 95% CI 1.37-6.44, p = .010) were independent predictors of MACEs. Kaplan-Meier analysis revealed that PCR was significantly associated with more frequent MACEs. The detection of PCR in the aorta using NOA was significantly associated with an increased risk of subsequent adverse events after PCI.
Sections du résumé
OBJECTIVE
This study aimed to investigate the prevalence and prognostic significance of atherosclerotic aortic plaques (AAPs) or specific AAP types detected by nonobstructive angioscopy (NOA) in patients who underwent percutaneous coronary intervention (PCI).
BACKGROUND
Although recent studies have reported the presence of various patterns of AAPs, identified by NOA, the clinical significance of the presence of AAPs remains elusive.
METHODS
In this retrospective, multicenter cohort study, a total of 167 patients who underwent PCI and intra-aortic scans with NOA were studied. The association between AAPs and the incidence of major adverse cardiac events (MACEs), including cardiac death, myocardial infarction, stroke, and clinically driven unplanned revascularizations, was assessed.
RESULTS
AAPs were detected in 126 patients (75%) who underwent NOA. MACEs occurred in 28 (17%) patients during the follow-up (median 2.9 years [range 2.1-3.8]). Among all types of AAPs, only puff-chandelier rupture (PCR) showed a significant difference in frequency between patients with and those without MACEs: 21 (75%) and 49 (35%), respectively (p < .001). Multivariable Cox proportional hazard analysis revealed that PCR (hazard ratio [HR] 3.73, 95% confidence interval [CI] 1.57-8.87, p = .004) and chronic kidney disease (HR 2.97, 95% CI 1.37-6.44, p = .010) were independent predictors of MACEs. Kaplan-Meier analysis revealed that PCR was significantly associated with more frequent MACEs.
CONCLUSION
The detection of PCR in the aorta using NOA was significantly associated with an increased risk of subsequent adverse events after PCI.
Types de publication
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
784-792Informations de copyright
© 2019 Wiley Periodicals, Inc.
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