title: Impact of plaque composition on long-term clinical outcomes in patients with coronary artery occlusive disease.
abstract: OBJECTIVE
  It is unclear which plaque component is related with long-term clinical outcomes in patients with coronary artery occlusive disease (CAOD). We assessed the relationship between plaque compositions and long-term clinical outcomes in those patients.
  
  
  METHODS
  The study subjects consisted of 339 consecutive patients (mean 61.7±12.2 years old, 239 males) who underwent coronary angiogram and a virtual histology-intravascular ultrasound examination. Major adverse cardiac and cerebrovascular events (MACCE), including all-cause death, non-fatal myocardial infarction, cerebrovascular events, and target vessel revascularization were evaluated during a mean 28-month follow-up period.
  
  
  RESULTS
  Patients with high fibrofatty volume (FFV, >8.90 mm(3), n=169) had a higher incidence of MACCE (25.4% vs. 14.7%, p=0.015), male sex (75.7% vs. 65.3%, p=0.043), acute coronary syndrome (53.3% vs. 35.9%, p=0.002), multivessel disease (62.7% vs. 41.8%, p<0.001) and post-stent slow flow (10.7% vs. 2.4%, p=0.002) than those with low FFV (FFV≤8.90 mm(3), n=170). Other plaque composition factors such as fibrous area/volume, dense calcified area/volume, and necrotic core area/volume did not show any impact on MACCE. Cardiogenic shock {hazard ratio (HR)=8.44; 95% confidence interval (CI)=3.00-23.79; p<0.001} and FFV (HR=1.85; 95% CI=1.12-3.07; p=0.016) were the independent predictors of MACCE by Cox regression analysis. Thin-cap fibroatheroma, necrotic core area, and necrotic core volume were not associated with MACCE.
  
  
  CONCLUSIONS
  FFV of a culprit lesion was associated with unfavorable long-term clinical outcomes in patients with CAOD.
authors.affiliation: Division of Cardiology, Konyang University Hospital, Daejeon, Korea.
authors.forename: Ki Hong
authors.initials: KH
authors.lastname: Kim
authors.forename: Wan Ho
authors.initials: WH
authors.lastname: Kim
authors.forename: Hyun Woong
authors.initials: HW
authors.lastname: Park
authors.forename: In Girl
authors.initials: IG
authors.lastname: Song
authors.forename: Dong Ju
authors.initials: DJ
authors.lastname: Yang
authors.forename: Young Hoon
authors.initials: YH
authors.lastname: Seo
authors.forename: Hyung Bin
authors.initials: HB
authors.lastname: Yuk
authors.forename: Yo Han
authors.initials: YH
authors.lastname: Park
authors.forename: Taek Geun
authors.initials: TG
authors.lastname: Kwon
authors.forename: Charanjit S
authors.initials: CS
authors.lastname: Rihal
authors.forename: Amir
authors.initials: A
authors.lastname: Lerman
authors.forename: Moo-Sik
authors.initials: MS
authors.lastname: Lee
authors.forename: Jang-Ho
authors.initials: JH
authors.lastname: Bae
keywords: Coronary artery disease; Intravascular ultrasonography; Plaque, atherosclerotic