KMID : 0880520180540030190
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Chonnam Medical Journal 2018 Volume.54 No. 3 p.190 ~ p.196
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Predictors of Clinical Outcome in Patients with Angiographically Intermediate Lesions with Minimum Lumen Area Less than 4 mm2 Using Intravascular Ultrasound in Non-Proximal Epicardial Coronary Artery
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Won Ju-Min
Hong Young-Joon Hyun Dae-Yong Jeong Hyung-Ki Oh Sung-Sik Kim Hyung-Yoon Kim Yong-Cheol Park Hyuk-Jin Kim Min-Chul Cho Jae-Yeong Lee Ki-Hong Sim Doo-Sun Yoon Nam-Sik Yoon Hyun-Ju Kim Kye-Hun Park Hyung-Wook Kim Ju-Han Ahn Young-Keun Jeong Myung-Ho Cho Jeong-Gwan Park Jong-Chun
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Abstract
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We investigated predictors of major adverse cardiac events (MACE) with two years after medical treatment for lesions with angiographically intermediate lesions with intravascular ultrasound (IVUS) minimum lumen area (MLA) <4 mm2 in non-proximal epicardial coronary artery. We retrospectively enrolled 104 patients (57 males, 62¡¾10 years) with angiographically intermediate lesions (diameter stenosis 30?70%) with IVUS MLA <4 mm2 in the non-proximal epicardial coronary artery with a reference lumen diameter between 2.25 and 3.0 mm. We evaluated the incidences of major adverse cardiovascular events (MACE including death, myocardial infarction, target lesion and target vessel revascularizations, and cerebrovascular accident) two years after medical therapy. During the two-year follow-up, 15 MACEs (14.4%) (including 1 death, 2 myocardial infarctions, 10 target vessel revascularizations, and 2 cerebrovascular accidents) occurred. Diabetes mellitus was more prevalent (46.7% vs. 18.0%, p=0.013) and statins were used less frequently in patients with MACE compared with those without MACE (40.0% vs. 71.9%, p=0.015). Independent predictors of MACEs with two years included diabetes mellitus (odds ratio [OR]=3.41; 95% CI=1.43?8.39, p=0.020) and non-statin therapy (OR=3.11; 95% CI=1.14?6.50, p=0.027). Long-term event rates are relatively low with only medical therapy without any intervention, so the cut-off of IVUS MLA 4 mm2 might be too large to be applied for defining significant stenosis. The predictors of long-term MACE were diabetes mellitus and statin therapy in patients with angiographically intermediate lesions in non-proximal epicardial coronary artery.
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KEYWORD
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Coronary Artery Disease, Plaque, Atherosclerotic, Ultrasonography, Interventional
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