title: Prognostic impact of lipid contents on the target lesion in patients with drug eluting stent implantation.
abstract: We sought to determine the morphologic predictors of major adverse cardiac events (MACEs) after successful percutaneous coronary intervention (PCI) with drug-eluting stents (DES), using integrated backscatter intravascular ultrasound (IB-IVUS). Conventional IVUS and IB-IVUS were performed in 260 consecutive patients who underwent PCI with DES. Three-dimensional analyses were performed to determine plaque volume and the volume of each plaque component (lipid, fibrous, and calcification). Patients were divided into two groups according to the median lipid volume (LV) in the target lesion. MACEs were defined as death, nonfatal myocardial infarction, and any repeat revascularization. The median follow-up interval was 1285 days. MACEs were observed in 64 patients (24.6 %). Patients having a larger LV compared with their counterparts had worse long-term clinical outcomes regarding mortality (3.8 vs. 0 %, P = 0.02) and MACEs (31.5 vs. 17.7 %, P = 0.008) by log-rank test. After adjustment for confounders, large LV (odds ratio 1.95, 95 % confidence interval 1.14-3.33, P = 0.02) was significantly and independently associated with MACEs. The assessment of coronary plaque characteristics in the target lesion may be useful to predict long-term outcome following successful coronary intervention.
authors.affiliation: Department of Cardiology, Aichi Medical University, 1-1 Karimata, Yazako, Nagakute, Aichi, 480-1195, Japan, kumagais@aichi-med-u.ac.jp.
authors.forename: Soichiro
authors.initials: S
authors.lastname: Kumagai
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Takashima
authors.forename: Katsuhisa
authors.initials: K
authors.lastname: Waseda
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Ando
authors.forename: Akihiro
authors.initials: A
authors.lastname: Suzuki
authors.forename: Tadayuki
authors.initials: T
authors.lastname: Uetani
authors.forename: Ken
authors.initials: K
authors.lastname: Harada
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Yoshida
authors.forename: Ayako
authors.initials: A
authors.lastname: Kunimura
authors.forename: Yusaku
authors.initials: Y
authors.lastname: Shimbo
authors.forename: Katsuhide
authors.initials: K
authors.lastname: Kitagawa
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Harada
authors.forename: Hideki
authors.initials: H
authors.lastname: Ishii
authors.forename: Daiji
authors.initials: D
authors.lastname: Yoshikawa
authors.forename: Tatsuaki
authors.initials: T
authors.lastname: Matsubara
authors.forename: Toyoaki
authors.initials: T
authors.lastname: Murohara
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Amano
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000379:methods; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000378:metabolism / Q000401:mortality / Q000628:therapy; D054855:Drug-Eluting Stents; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan; D008055:Lipids / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000209:etiology / Q000378:metabolism / Q000473:pathology; D011183:Postoperative Complications / Q000209:etiology / Q000378:metabolism / Q000473:pathology; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D020123:Sirolimus; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods
chemical_list: D008055:Lipids; D020123:Sirolimus