Coronary plaque and clinical characteristics of South Asian (Indian) patients with acute coronary syndromes: An optical coherence tomography study.

Acute Coronary Syndrome / diagnostic imaging Asian People Coronary Angiography Coronary Artery Disease / diagnostic imaging Coronary Vessels / diagnostic imaging Humans Plaque, Atherosclerotic / diagnostic imaging Tomography, Optical Coherence

Acute coronary syndrome Layered plaque Optical coherence tomography Plaque erosion Plaque vulnerability South Asians

Journal

International journal of cardiology

ISSN: 1874-1754

Titre abrégé: Int J Cardiol

Pays: Netherlands

ID NLM: 8200291

Informations de publication

Date de publication:
15 Nov 2021

Historique:

received: 03 06 2021

revised: 02 08 2021

accepted: 30 08 2021

pubmed: 7 9 2021

medline: 21 10 2021

entrez: 6 9 2021

Statut: ppublish

Résumé

South Asians, and Indians in particular, are known to have a higher incidence of premature atherosclerosis and acute coronary syndromes (ACS) with worse clinical outcomes, compared to populations with different ethnic backgrounds. However, the underlying pathobiology accounting for these differences has not been fully elucidated. ACS patients who had culprit lesion optical coherence tomography (OCT) imaging were enrolled. Culprit plaque characteristics were evaluated using OCT. Among 1315 patients, 100 were South Asian, 1009 were East Asian, and 206 were White. South Asian patients were younger (South Asians vs. East Asians vs. Whites: 51.6 ± 13.4 vs. 65.4 ± 11.9 vs. 62.7 ± 11.7; p < 0.001) and more frequently presented with ST-segment elevation myocardial infarction (STEMI) (77.0% vs. 56.4% vs. 35.4%; p < 0.001). On OCT analysis after propensity group matching, plaque erosion was more frequent (57.0% vs. 38.0% vs. 50.0%; p = 0.003), the lipid index was significantly greater (2281.6 [1570.8-3160.6] vs. 1624.3 [940.9-2352.4] vs. 1303.8 [1090.0-1757.7]; p < 0.001), and the prevalence of layered plaque was significantly higher in the South Asian group than in the other two groups (52.0% vs. 30.0% vs. 34.0%; p = 0.003). Compared to East Asians and Whites, South Asians with ACS were younger and more frequently presented with STEMI. Plaque erosion was the predominant pathology for ACS in South Asians and their culprit lesions had more features of plaque vulnerability. http://www.clinicaltrials.gov, NCT03479723.

Sections du résumé

BACKGROUND BACKGROUND

METHODS METHODS

ACS patients who had culprit lesion optical coherence tomography (OCT) imaging were enrolled. Culprit plaque characteristics were evaluated using OCT.

RESULTS RESULTS

Among 1315 patients, 100 were South Asian, 1009 were East Asian, and 206 were White. South Asian patients were younger (South Asians vs. East Asians vs. Whites: 51.6 ± 13.4 vs. 65.4 ± 11.9 vs. 62.7 ± 11.7; p < 0.001) and more frequently presented with ST-segment elevation myocardial infarction (STEMI) (77.0% vs. 56.4% vs. 35.4%; p < 0.001). On OCT analysis after propensity group matching, plaque erosion was more frequent (57.0% vs. 38.0% vs. 50.0%; p = 0.003), the lipid index was significantly greater (2281.6 [1570.8-3160.6] vs. 1624.3 [940.9-2352.4] vs. 1303.8 [1090.0-1757.7]; p < 0.001), and the prevalence of layered plaque was significantly higher in the South Asian group than in the other two groups (52.0% vs. 30.0% vs. 34.0%; p = 0.003).

CONCLUSIONS CONCLUSIONS

Compared to East Asians and Whites, South Asians with ACS were younger and more frequently presented with STEMI. Plaque erosion was the predominant pathology for ACS in South Asians and their culprit lesions had more features of plaque vulnerability.

CLINICAL TRIAL REGISTRATION BACKGROUND

http://www.clinicaltrials.gov, NCT03479723.

Identifiants

DOI: 10.1016/j.ijcard.2021.08.048 PMID: 34487786

pubmed: 34487786

pii: S0167-5273(21)01316-4

doi: 10.1016/j.ijcard.2021.08.048

pii:

doi:

Banques de données

ClinicalTrials.gov

['NCT03479723']

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

Pagination

171-179