title: Impact of spotty calcification on long-term prediction of future revascularization: a prospective three-vessel intravascular ultrasound study.
abstract: To date, there are no prospective studies on the relationship between plaque characteristics identified by 40 MHz IVUS and future adverse events. This prospective study evaluated the relationship between plaque morphology in nonculprit nonsignificant lesions, determined by 40 MHz IVUS, and long-term clinical outcomes. Consecutively, 45 patients who underwent 3-vessel intravascular ultrasound (IVUS) examinations were prospectively enrolled. Qualitative and quantitative IVUS analyses including scoring of echogenicity for assessment of plaque characterization were performed for each nonsignificant nonculprit lesion. The number, the length, the location (superficial or deep), and maximum arc were measured for each calcium deposit within plaques. Spotty calcification was defined as calcium deposits <90° and <6 mm in length. Primary end point was defined as nonsignificant nonculprit lesion-related revascularization (NNLR) during 6 years of follow-up. A total of 163 nonsignificant nonculprit lesions with mild to moderate stenosis were identified on baseline 3-vessel IVUS. Of those 163 lesions, six lesions required NNLR during the follow-up period. There were no differences in quantitative IVUS parameters including remodeling index, plaque burden, and echogenicity between lesions requiring and not requiring NNLR. However, deep spotty calcification was more frequently identified in lesions requiring NNLR than in those not requiring NNLR (33 vs. 8 %, P = 0.02). Spotty calcium deposits identified by 40 MHz IVUS predicted the need for NNLR during a 6-year follow-up period. This finding suggests that deep spotty calcium may be a surrogate marker for plaque progression and the subsequent need for revascularization in the future.
authors.affiliation: Cardiovascular Division, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 6638501, Japan.
authors.forename: Hiroto
authors.initials: H
authors.lastname: Tamaru
authors.affiliation: Cardiovascular Division, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 6638501, Japan. kfujii@hyo-med.ac.jp.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Fujii
authors.affiliation: Cardiovascular Division, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 6638501, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Fukunaga
authors.affiliation: Cardiovascular Division, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 6638501, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Imanaka
authors.affiliation: Cardiovascular Division, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 6638501, Japan.
authors.forename: Kojiro
authors.initials: K
authors.lastname: Miki
authors.affiliation: Cardiovascular Division, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 6638501, Japan.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Horimatsu
authors.affiliation: Cardiovascular Division, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 6638501, Japan.
authors.forename: Machiko
authors.initials: M
authors.lastname: Nishimura
authors.affiliation: Cardiovascular Division, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 6638501, Japan.
authors.forename: Ten
authors.initials: T
authors.lastname: Saita
authors.affiliation: Cardiovascular Division, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 6638501, Japan.
authors.forename: Akinori
authors.initials: A
authors.lastname: Sumiyoshi
authors.affiliation: Cardiovascular Division, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 6638501, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Shibuya
authors.affiliation: Cardiovascular Division, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 6638501, Japan.
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Naito
authors.affiliation: Cardiovascular Division, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 6638501, Japan.
authors.forename: Tohru
authors.initials: T
authors.lastname: Masuyama
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000628:therapy*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000628:therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000473:pathology; D018450:Disease Progression; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D018084:Ultrasonography, Interventional; D061205:Vascular Calcification / Q000000981:diagnostic imaging* / Q000628:therapy*
keywords: Calcification; Coronary artery disease; Intravascular ultrasound; Revascularization