Lipid-Rich Plaques Predict Non-Target-Lesion Ischemic Events in Patients Undergoing Percutaneous Coronary Intervention : Insights From Integrated Backscatter Intravascular Ultrasound

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<b><i>Background:</i></b> Despite growing interest in non-target lesion events in patients undergoing percutaneous coronary intervention (PCI), there has been little discussion of predictors. <b><i>Methods and Results:</i></b> A total of 155 consecutive patients who underwent PCI were enrolled. Conventional and integrated backscatter intravascular ultrasound (IB-IVUS) parameters were measured in non-target lesions utilizing a 40-MHz intravascular catheter. Lipid-rich plaques (LRP) were defined as lesions with an increased lipid volume (>median) and greater lipid content. Non-target ischemic events were defined as death, non-fatal myocardial infarction, any repeat revascularization and rehospitalization for angina involving the non-target vessel or the target vessel outside the index lesion. During the follow-up period (median: 1,265 days), non-target events were observed in 16 patients (11%). Using the Cox proportional hazard model, LRP (odds ratio [OR], 6.06; 95% confidence interval [CI]: 1.81-20.4, P=0.0035), elevated serum C-reactive protein (CRP) levels (OR, 6.83; 95%CI: 2.19-21.3, P=0.0009) and acute coronary syndrome present at baseline (OR, 4.08; 95%CI: 1.21-13.8, P=0.024) were significantly and independently associated with non-target events. Synergistic effects of LRP and elevated serum CRP levels for prediction of non-target events (OR, 14.8; 95%CI: 4.57-48.0, P<0.0001) were found even after adjusting for confounders. <b><i>Conclusions:</i></b> LRP measured using IB-IVUS proved to be an independent morphologic predictor of non-target ischemic events after PCI, particularly enhancing the risk in patients with elevated serum CRP levels. (<i>Circ J</i> 2011; <b>75:</b> 157-166)<br>


  • Circulation Journal

    Circulation Journal 75(1), 157-166, 2010-12-25

    The Japanese Circulation Society

References:  31

Cited by:  2


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