title: Long-term prognostic impact of the attenuated plaque in patients with acute coronary syndrome.
abstract: Several intravascular ultrasound studies have reported that culprit lesion-attenuated plaque (AP) is related to slow flow/no reflow after percutaneous coronary intervention (PCI). Long-term prognostic impact of the AP is unknown. The aim of this study was to investigate acute and long-term clinical impact of the AP in patients with acute coronary syndrome (ACS). A total of 110 ACS patients who underwent successful PCI were enrolled. Acute and long-term clinical outcomes were compared between patients with AP (AP group: n = 73) and those without AP (non-AP group: n = 37). Long-term cardiac event was defined as a composite of death and ACS. Baseline characteristics in 2 groups were similar. AP was associated with higher TIMI frame count immediately after the first balloon inflation. After thrombectomy and intracoronary drug administration, final TIMI frame count became similar between AP and non-AP group. Although AP was associated with higher incidence of fatal arrhythmia during hospitalization, in-hospital mortality did not differ between the 2 groups. During follow-up (median 6.2 years), cardiac event-free survival did not differ between the 2 groups. Despite the initial unfavorable effect on coronary reflow, presence of AP did not affect acute as well as long-term clinical outcome in patients with ACS.
authors.affiliation: The Division of Cardiology, Bell Land General Hospital, Sakai, Japan. hokura@fides.dti.ne.jp.|The Division of Cardiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192, Japan. hokura@fides.dti.ne.jp.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Okura
authors.affiliation: The Division of Cardiology, Bell Land General Hospital, Sakai, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Kataoka
authors.affiliation: The Division of Internal Medicine and Cardiology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Yoshiyama
authors.affiliation: The Division of Internal Medicine and Cardiology, Nishinomiya Watanabe Cardiovascular Center, Nishinomiya, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Yoshikawa
authors.affiliation: The Division of Cardiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Yoshida
mesh_terms: D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging* / Q000401:mortality* / Q000628:therapy; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D001241:Aspirin / Q000627:therapeutic use; D017023:Coronary Angiography; D003326:Coronary Circulation; D018572:Disease-Free Survival; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011379:Prognosis; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D010975:Platelet Aggregation Inhibitors; D001241:Aspirin
keywords: Acute coronary syndrome; Atherosclerosis; IVUS; Stent