title: Plaque regression determined by intravascular ultrasound predicts long-term outcomes of patients with acute coronary syndrome.
abstract: OBJECTIVE
  The usefulness of drugs to treat plaque regression is assessed by intravascular ultrasound (IVUS); however, the impact of plaque regression on clinical outcomes in patients with acute coronary syndrome (ACS) has not been established; therefore, we investigated the relationship between coronary plaque regression and long-term clinical outcomes.
  
  
  METHODS
  We analyzed data from 86 patients who underwent percutaneous coronary intervention (PCI) and who were assessed in detail at baseline and at 6 months of follow-up by measuring proximal non-culprit sites of PCI lesions using volumetric IVUS. Patients were divided according to changes in plaque volume over 6 months into one group with plaque regression (n =55; 64.0%) and another with progression (n =31; 36.0%). They were followed up observationally for a mean of 1,736 days.
  
  
  RESULTS
  Baseline characteristics at the time of ACS were similar between the groups. The probability of event-free survival was significantly higher in the regression group than in the progression group as estimated by the Kaplan-Meier method (Log-rank test, p =0.032). Furthermore, the Cox hazards model revealed the relative contribution of plaque regression as a predictor of cardiovascular events (hazard ratio: 0.26; 95% CI, 0.07 to 0.83; p =0.023).
  
  
  CONCLUSIONS
  Plaque regression determined by volumetric IVUS over a period of 6 months was associated with a lower rate of cardiovascular events among patients with ACS. This study also demonstrated that plaque regression could be a surrogate marker of future cardiovascular events.
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University School of Medicine, Bunkyo-ku, Tokyo, Japan.
authors.forename: Tomotaka
authors.initials: T
authors.lastname: Dohi
authors.forename: Katsumi
authors.initials: K
authors.lastname: Miyauchi
authors.forename: Shinya
authors.initials: S
authors.lastname: Okazaki
authors.forename: Takayuki
authors.initials: T
authors.lastname: Yokoyama
authors.forename: Naotake
authors.initials: N
authors.lastname: Yanagisawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tamura
authors.forename: Takahiko
authors.initials: T
authors.lastname: Kojima
authors.forename: Ken
authors.initials: K
authors.lastname: Yokoyama
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kurata
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Daida
mesh_terms: D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000628:therapy; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging*; D015996:Survival Rate; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional