Age-related differences in virtual histology-intravascular ultrasound findings in patients with coronary artery disease.
BACKGROUND
We assessed the age-related differences in pre-intervention virtual histology-intravascular ultrasound (VH-IVUS) findings at target lesion sites in patients with coronary artery disease.


METHODS
A total of 553 patients who underwent pre-intervention VH-IVUS imaging were grouped according to age: non-elderly (< or = 70 years, n=429) and elderly (>70 years, n=124); 191 had stable angina and 362 acute coronary syndrome. VH-IVUS classified the tissue into: fibrotic, fibro-fatty, dense calcium (DC), and necrotic core (NC).


RESULTS
Overall, the absolute and percent volumes of DC (11.0 + or - 11.0mm(3) vs. 9.7 + or - 11.9 mm(3), P=0.033; 11.7 + or - 8.1% vs. 9.8 + or - 7.2%, P=0.014, respectively) and NC (18.5 + or - 17.6mm(3) vs. 16.6 + or - 18.9 mm(3), P=0.020; 18.8 + or - 8.8% vs. 16.5 + or - 9.3%, P=0.026, respectively) were significantly greater in the elderly than in the non-elderly. In stable angina patients, the absolute and percent volumes of DC (10.4 + or - 9.9 mm(3) vs. 7.2 + or - 7.6 mm(3), P=0.022; 13.4 + or - 10.0% vs. 9.2 + or - 6.5%, P=0.011, respectively) and NC (14.8 + or - 11.2 mm(3) vs. 12.0 + or - 11.9 mm(3), P=0.035; 19.6 + or - 8.8% vs. 15.5 + or - 8.4%, P=0.006, respectively) were significantly greater in the elderly. However, in acute coronary syndrome patients, there were no significant differences in absolute and percent volumes of DC (11.4 + or - 11.6 mm(3) vs. 10.9 + or - 13.4 mm(3), P=0.8; 10.7 + or - 6.5% vs. 10.1 + or - 7.5%, P=0.5, respectively) and NC (24.1 + or - 20.3 mm(3) vs. 23.9 + or - 21.2 mm(3), P=0.9; 22.0 + or - 8.8% vs. 21.3 + or - 9.6%, P=0.6, respectively) between the elderly and non-elderly groups. Myocardial infarction (OR: 2.56, 95% CI: 1.45-4.12, P=0.003), diabetes mellitus (OR: 2.23, 95% CI: 1.30-3.53, P=0.009), and high-sensitivity C-reactive protein (OR: 1.44, 95% CI: 1.06-2.45, P=0.042), but not age, were independent predictors of percent NC volume >20% in lesion site.


CONCLUSIONS
Myocardial infarction, diabetes mellitus, and high-sensitivity C-reactive protein, but not age, were associated with NC-rich lesions. Clinical presentation, risk factors, and inflammatory status, but not age, are important factors for plaque components.
Hong
Young Joon
YJ
Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, 671 Jaebongro, Dong-gu, Gwangju 501-757, Republic of Korea.
Jeong
Myung Ho
MH
Choi
Yun Ha
YH
Ma
Eun Hye
EH
Ko
Jum Suk
JS
Lee
Min Goo
MG
Park
Keun Ho
KH
Sim
Doo Sun
DS
Yoon
Nam Sik
NS
Youn
Hyun Ju
HJ
Kim
Kye Hun
KH
Park
Hyung Wook
HW
Kim
Ju Han
JH
Ahn
Youngkeun
Y
Cho
Jeong Gwan
JG
Park
Jong Chun
JC
Kang
Jung Chaee
JC
D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging / Q000473:pathology; D000367:Age Factors; D000368:Aged; D000787:Angina Pectoris / Q000000981:diagnostic imaging / Q000473:pathology; D002097:C-Reactive Protein / Q000032:analysis; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000473:pathology*; D048909:Diabetes Complications; D006801:Humans; D009203:Myocardial Infarction / Q000150:complications; D018084:Ultrasonography, Interventional; D014584:User-Computer Interface
D002097:C-Reactive Protein