2-Year Outcomes After Stenting of Lipid-Rich and Nonrich Coronary Plaques
Myong Hwa Yamamoto, Akiko Maehara, Gregg W. Stone, Annapoorna Kini, Emmanouil S. Brilakis, David G. Rizik, Kendrick Shunk, Eric R. Powers, Jonathan M. Tobis, Brijeshwar Maini, Simon Dixon, James A. Goldstein, John L. Petersen, Philippe Généreux, Priti Shah, Aaron Crowley, Stephen J. Nicholls, Gary S. Mintz, James E. Muller, Giora Weisz
Abstract
BACKGROUND: Autopsy studies suggest that implanting stents in lipid-rich plaque (LRP) may be associated with adverse outcomes. OBJECTIVES: The purpose of this study was to evaluate the association between LRP detected by near-infrared spectroscopy (NIRS) and clinical outcomes in patients with coronary artery disease treated with contemporary drug-eluting stents. METHODS: was defined as the maximum LCBI within any 4-mm-long segment. Major adverse cardiac events (MACE) included cardiac death, myocardial infarction, definite or probable stent thrombosis, or unplanned revascularization or rehospitalization for progressive angina or unstable angina. Events were subcategorized as culprit (treated) lesion-related, nonculprit (untreated) lesion-related, or indeterminate. RESULTS: per 100: 1.06; 95% confidence interval: 0.96 to 1.17; p = 0.28) after adjusting clinical and procedural factors. CONCLUSIONS: Following PCI with contemporary drug-eluting stents, stent implantation in NIRS-defined LRPs was not associated with increased periprocedural or late adverse outcomes compared with those without significant lipid.