title: Comparison of clinical characteristics and arterial remodeling by intravascular ultrasonic imaging in three age groups (< or =55, 56 to 69 and > or =70 years) of Japanese patients with acute myocardial infarction.
abstract: Recent epidemiologic, pathologic, and intravascular ultrasound (IVUS) studies have shown that there are differences in coronary risk factors or plaque morphology between younger and older patients with acute myocardial infarctions (AMIs). This study examined clinical background and plaque morphology using IVUS in younger and older adults with AMIs in Japan. The study population consisted of 96 patients with AMIs, for whom preinterventional IVUS images were obtained. Patients were classified into 3 groups: a young group (aged < or =55 years), a middle-aged group (aged 56 to 69 years), and an old group (aged > or =70 years). The remodeling index was defined as the ratio of the external elastic membrane area at the culprit lesion to the external elastic membrane area at the proximal reference site. Expansive remodeling was defined as a remodeling index >1.05 and constrictive remodeling as a remodeling index <0.95. The frequency of hypercholesterolemia was significantly different among the 3 age groups. Total cholesterol (p <0.001), low-density lipoprotein cholesterol (p <0.005), and triglyceride (p <0.05) levels and body mass index (p <0.001) in the young group were significantly higher than in the old group. On IVUS images, constrictive remodeling was most common in the young group, whereas expansive remodeling occurred most commonly in the middle-aged and old groups. In conclusion, this study demonstrated that patients with AMIs in the young group had higher levels of hypercholesterolemia, obesity, and constrictive remodeling compared with those in the old group. The differences in arterial remodeling of the culprit lesions between younger and older patients with AMIs may reflect different biologic mechanisms of plaque activation and destabilization.
authors: Department of Internal Medicine and Cardiology, Osaka City University Graduate School of Medicine, Osaka, Japan. ehara@med.osaka-cu.ac.jp
authors: Shoichi
authors: S
authors: Ehara
authors: Takahiko
authors: T
authors: Naruko
authors: Yoshiki
authors: Y
authors: Kobayashi
authors: Toru
authors: T
authors: Kataoka
authors: Masashi
authors: M
authors: Nakagawa
authors: Nobuyuki
authors: N
authors: Shirai
authors: Hideshi
authors: H
authors: Ishii
authors: Takuhiro
authors: T
authors: Okuyama
authors: Hiroki
authors: H
authors: Oe
authors: Kenichi
authors: K
authors: Sugioka
authors: Takeshi
authors: T
authors: Hozumi
authors: Kazuo
authors: K
authors: Haze
authors: Junichi
authors: J
authors: Yoshikawa
authors: Minoru
authors: M
authors: Yoshiyama
authors: Makiko
authors: M
authors: Ueda
mesh_terms: D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D015897:Comorbidity; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000000981:diagnostic imaging* / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology; D012307:Risk Factors; D018084:Ultrasonography, Interventional