title: Fibro-Fatty Component is Important for the Long-Term Clinical Events in Patients Who Have Undergone Primary Percutaneous Coronary Intervention.
abstract: OBJECTIVE
  We evaluated which plaque components are associated with long-term clinical events in patients who underwent primary percutaneous coronary intervention (PCI).
  
  
  METHODS
  The study subjects consisted of 57 consecutive patients (mean age, 58.5±14.5 years; 45 males) who underwent primary PCI and a virtual histology-intravascular ultrasound examination. Major adverse cardiac events (MACEs) including death, acute myocardial infarction, stroke, and revascularization were evaluated during the mean 28 month follow-up period.
  
  
  RESULTS
  Patients with high fibro-fatty volume (FFV >13.4 mm(3), n=29; mean age, 61.3 years) had a lower ejection fraction (52.7% vs. 59.4%, p=0.022), a higher incidence of multi-vessel disease (69.0% vs. 28.6%, p=0.002), larger plaque area (25.7 mm(2) vs. 15.9 mm(2), p<0.001), and larger plaque volume (315 mm(3) vs. 142 mm(3), p<0.001) than those with a low FFV (≤13.4 mm(3), n=28; mean age, 55.6 years). Patients with high FFV had a significantly higher incidence (32.1% vs. 8.3%, p=0.036) of MACE than those with low FFV. When we divided the study population according to the necrotic core volume (NCV), fibrous volume, or dense calcified volume, no significant findings in terms of demographics and MACE rates were observed. A Cox regression analysis revealed that the independent factor for MACE was FFV (hazard ratio, 6.748; 95% confidence interval, 1.168-38.971, p=0.033) in this study population.
  
  
  CONCLUSIONS
  The coronary plaque component, particularly FFV, but not NCV, was important in long-term clinical outcomes in patients who underwent primary PCI.
authors.affiliation: Division of Cardiology, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: Wan Ho
authors.initials: WH
authors.lastname: Kim
authors.forename: Hyun Woong
authors.initials: HW
authors.lastname: Park
authors.forename: Ki Hong
authors.initials: KH
authors.lastname: Kim
authors.forename: In Girl
authors.initials: IG
authors.lastname: Song
authors.forename: Dong Ju
authors.initials: DJ
authors.lastname: Yang
authors.forename: Chung Seop
authors.initials: CS
authors.lastname: Lee
authors.forename: Young Hoon
authors.initials: YH
authors.lastname: Seo
authors.forename: Taek Geun
authors.initials: TG
authors.lastname: Kwon
authors.forename: Jang-Ho
authors.initials: JH
authors.lastname: Bae