Disparities among Black and White patients in plaque burden and composition and long-term impact.
Female
Humans
Male
Coronary Angiography
/ adverse effects
Coronary Artery Disease
/ diagnostic imaging
Coronary Vessels
/ diagnostic imaging
Lipids
Myocardial Infarction
/ etiology
Plaque, Atherosclerotic
Predictive Value of Tests
Ultrasonography, Interventional
/ methods
Black or African American
White
Coronary atherosclerosis
Intravascular imaging
Lipid-rich plaque
Near-infrared spectroscopy
Racial disparities
Vulnerable plaque
Journal
Cardiovascular revascularization medicine : including molecular interventions
ISSN: 1878-0938
Titre abrégé: Cardiovasc Revasc Med
Pays: United States
ID NLM: 101238551
Informations de publication
Date de publication:
10 2023
10 2023
Historique:
received:
27
04
2023
accepted:
27
04
2023
medline:
6
11
2023
pubmed:
5
6
2023
entrez:
4
6
2023
Statut:
ppublish
Résumé
Black patients presenting to the catheterization laboratory have more risk factors and worse long-term outcomes. This sub-analysis of the Lipid Rich Plaque (LRP) study quantifies the plaque burden and composition of Black vs White patients and associated outcomes. Patients with a singular, self-reported race presenting for cardiac catheterization were enrolled if near-infrared spectroscopy/intravascular ultrasound (NIRS-IVUS) imaging of non-stented, non-culprit (NC) vessels was performed. Lipidic content was quantified at the 4-mm region with maximum Lipid Core Burden Index (maxLCBI Among 1346 patients with a singular, self-reported race, 182 were Black. Black vs White patients were more likely to be female, had higher rates of traditional risk factors, and were more likely to present acutely. Both patients and segments were more likely to have maxLCBI Compared to White patients, Black patients had more lipid-rich plaques with greater plaque burden. Both high lipidic burden and Black race were independently predictive of NC-MACE within 2 years. https://clinicaltrials.gov/ct2/show/NCT02033694, NCT02033694.
Sections du résumé
BACKGROUND
Black patients presenting to the catheterization laboratory have more risk factors and worse long-term outcomes. This sub-analysis of the Lipid Rich Plaque (LRP) study quantifies the plaque burden and composition of Black vs White patients and associated outcomes.
METHODS
Patients with a singular, self-reported race presenting for cardiac catheterization were enrolled if near-infrared spectroscopy/intravascular ultrasound (NIRS-IVUS) imaging of non-stented, non-culprit (NC) vessels was performed. Lipidic content was quantified at the 4-mm region with maximum Lipid Core Burden Index (maxLCBI
RESULTS
Among 1346 patients with a singular, self-reported race, 182 were Black. Black vs White patients were more likely to be female, had higher rates of traditional risk factors, and were more likely to present acutely. Both patients and segments were more likely to have maxLCBI
CONCLUSIONS
Compared to White patients, Black patients had more lipid-rich plaques with greater plaque burden. Both high lipidic burden and Black race were independently predictive of NC-MACE within 2 years.
CLINICAL TRIAL REGISTRATION
https://clinicaltrials.gov/ct2/show/NCT02033694, NCT02033694.
Identifiants
pubmed: 37271594
pii: S1553-8389(23)00165-3
doi: 10.1016/j.carrev.2023.04.023
pii:
doi:
Substances chimiques
Lipids
0
Banques de données
ClinicalTrials.gov
['NCT02033694']
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
28-32Informations de copyright
Copyright © 2023 Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Carlo Di Mario is the recipient of research grants (through the Department of Clinical & Experimental medicine of the University of Florence) from AMGEN, Behring, Chiesi, Daiichi-Sankyo, Edwards, Medtronic, and Shockwave. Ziad Ali reports grants from NIH/NHLBI, Abbott Vascular and Cardiovascular Systems Inc., personal fees from Amgen, AstraZeneca and Boston Scientific, and equity from Shockwave Medical. Hector Garcia-Garcia reports the following institutional grant support: Biotronik, Boston Scientific, Medtronic, Abbott, Neovasc, Shockwave, Philips, and CorFlow. Gary Mintz reports honoraria from Boston Scientific and Philips. Ron Waksman reports serving on the advisory boards of Abbott Vascular, Boston Scientific, Medtronic, Philips IGT, and Pi-Cardia Ltd.; being a consultant for Abbott Vascular, Biotronik, Boston Scientific, Cordis, Medtronic, Philips IGT, Pi-Cardia Ltd., Swiss Interventional Systems/SIS Medical AG, Transmural Systems Inc., and Venous MedTech; receiving institutional grant support from Amgen, Biotronik, Boston Scientific, Chiesi, Medtronic, and Philips IGT; and being an investor in MedAlliance and Transmural Systems Inc. All other authors report no conflicts of interest.