title: Association Between Prior Aspirin Use and Morphological Features of Culprit Lesions at First Presentation of Acute Coronary Syndrome Assessed by Optical Coherence Tomography.
abstract: The effect of prior use of aspirin (ASA) on the onset of acute coronary syndrome (ACS) has not been clarified. This study used optical coherence tomography (OCT) to investigate the morphological features of culprit lesions of ACS in patients with prior ASA use.
  
  
  
  In total, 442 patients with their first ACS episode undergoing OCT for the culprit lesions were investigated. Clinical characteristics, OCT findings, and adverse events at 30 days were compared between patients with prior ASA use and ASA-naïve patients (non-ASA). 67 patients (15.2%) had received ASA at presentation. The ASA group was older, had higher frequency of dyslipidemia and hypertension, and lower renal function than the non-ASA group. Non-ST-elevation ACS was more prevalent in the ASA than in the non-ASA group (79.1 vs. 53.6%, P<0.001). Propensity score matching yielded 49 patients in both groups. OCT revealed less frequent thrombi in the ASA than in the non-ASA group in both the entire (37.3 vs. 75.2%, P<0.001) and score-matched cohorts (38.8 vs. 75.5%, P<0.001), whereas no significant difference was observed in plaque characteristics. Rate of adverse events did not differ between the ASA and the non-ASA groups in the matched cohort.
  
  
  
  With a first ACS presentation, patients with prior ASA use were more likely to present with non-ST-elevation ACS with less frequent intraluminal thrombi, but no significant difference in underlying plaque characteristics or clinical course.
authors.affiliation: Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital.
authors.forename: Taishi
authors.initials: T
authors.lastname: Yonetsu
authors.forename: Tetsumin
authors.initials: T
authors.lastname: Lee
authors.forename: Tadashi
authors.initials: T
authors.lastname: Murai
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Kanno
authors.forename: Rikuta
authors.initials: R
authors.lastname: Hamaya
authors.forename: Sadamitsu
authors.initials: S
authors.lastname: Ichijo
authors.forename: Takayuki
authors.initials: T
authors.lastname: Niida
authors.forename: Masahiro
authors.initials: M
authors.lastname: Hada
authors.forename: Makoto
authors.initials: M
authors.lastname: Araki
authors.forename: Junji
authors.initials: J
authors.lastname: Matsuda
authors.forename: Eisuke
authors.initials: E
authors.lastname: Usui
authors.forename: Masahiro
authors.initials: M
authors.lastname: Hoshino
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Kanaji
authors.forename: Tsunekazu
authors.initials: T
authors.lastname: Kakuta
mesh_terms: D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology*; D000367:Age Factors; D000368:Aged; D001241:Aspirin / Q000494:pharmacology*; D016022:Case-Control Studies; D050171:Dyslipidemias / Q000209:etiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology; D007668:Kidney / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D013927:Thrombosis / Q000209:etiology; D041623:Tomography, Optical Coherence / Q000379:methods*
chemical_list: D001241:Aspirin