Dataset Information

Culprit Plaque Characteristics in Patients With Sleep-Disordered Breathing Undergoing Percutaneous Coronary Intervention: An Intravascular Ultrasound Study.

ABSTRACT: Background Sleep-disordered breathing ( SDB ) is a novel cardiovascular risk factor. However, the coronary plaque characteristics of patients with SDB with coronary artery disease are still unclear. Methods and Results This study included 289 consecutive patients with coronary artery disease undergoing percutaneous coronary intervention. Plaque characteristics of the culprit lesion were assessed by preintervention intravascular ultrasound. The presence of SDB was defined as a 3% oxygen desaturation index of ?15 events per hour measured by nocturnal pulse oximetry. Of 289 patients, the median 3% oxygen desaturation index was 9.6 (interquartile range, 5.1-16.6), and 88 patients (30.4%) were defined as having SDB . Compared with the no- SDB group, the SDB group had a larger total atheroma volume of the culprit lesion (224.5 mm3 versus 190.8 mm3, P=0.05). The median maximum attenuation and calcification angle were 140° and 130°, respectively. Attenuated plaque with a maximum attenuation angle >140° was more frequently observed in the SDB group compared with the no- SDB group (34.9% versus 22.6%; P=0.03). However, there were no statistically significant differences between groups in the maximum calcium angle and the frequency of calcific plaques with a maximum calcium angle >130°. Multivariable logistic regression analysis showed that the presence of SDB was a significant predictor of a greater ultrasound attenuation angle (>140°) (odds ratio, 1.86; 95% confidence interval, 1.02-3.39; P=0.04). Conclusions SDB was associated with larger atheroma plaque volume and a greater ultrasound attenuation, which are discriminators of plaque vulnerability. Further studies are needed to clarify the effects of SDB treatment on coronary plaque lesions.

SUBMITTER: Wada H

PROVIDER: S-EPMC6404903 | biostudies-literature | 2018 Oct

REPOSITORIES: biostudies-literature

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Culprit Plaque Characteristics in Patients With Sleep-Disordered Breathing Undergoing Percutaneous Coronary Intervention: An Intravascular Ultrasound Study.

Wada Hideki H Dohi Tomotaka T Kasai Takatoshi T Yatsu Shoichiro S Naito Ryo R Kato Yoshiteru Y Okai Iwao I Iwata Hiroshi H Isoda Kikuo K Okazaki Shinya S Miyauchi Katsumi K Daida Hiroyuki H

Journal of the American Heart Association 20181001 19

Background Sleep-disordered breathing ( SDB ) is a novel cardiovascular risk factor. However, the coronary plaque characteristics of patients with SDB with coronary artery disease are still unclear. Methods and Results This study included 289 consecutive patients with coronary artery disease undergoing percutaneous coronary intervention. Plaque characteristics of the culprit lesion were assessed by preintervention intravascular ultrasound. The presence of SDB was defined as a 3% oxygen desaturat ...[more]

PMID: 30371319

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Project description:BACKGROUND:Prospective data on the associations of adiponectin with in-vivo measurements of degree, phenotype and vulnerability of coronary atherosclerosis are currently lacking. OBJECTIVE:To investigate the association of plasma adiponectin with virtual histology intravascular ultrasound (VH-IVUS)-derived measures of atherosclerosis and with major adverse cardiac events (MACE) in patients with established coronary artery disease. METHODS:In 2008-2011, VH-IVUS of a non-culprit non-stenotic coronary segment was performed in 581 patients undergoing coronary angiography for acute coronary syndrome (ACS, n = 318) or stable angina pectoris (SAP, n = 263) from the atherosclerosis-intravascular ultrasound (ATHEROREMO-IVUS) study. Blood was sampled prior to coronary angiography. Coronary plaque burden, tissue composition, high-risk lesions, including VH-IVUS-derived thin-cap fibroatheroma (TCFA), were assessed. All-cause mortality, ACS, unplanned coronary revascularization were registered during a 1-year-follow-up. All statistical tests were two-tailed and p-values < 0.05 were considered statistically significant. RESULTS:In the full cohort, adiponectin levels were not associated with plaque burden, nor with the various VH-tissue types. In SAP patients, adiponectin levels (median[IQR]: 2.9(1.9-3.9) µg/mL) were positively associated with VH-IVUS derived TCFA lesions, (OR[95%CI]: 1.78[1.06-3.00], p = 0.030), and inversely associated with lesions with minimal luminal area (MLA) ? 4.0 mm2 (OR[95%CI]: 0.55[0.32-0.92], p = 0.025). In ACS patients, adiponectin levels (median[IQR]: 2.9 [1.8-4.1] µg/mL)were not associated with plaque burden, nor with tissue components. Positive association of adiponectin with death was present in the full cohort (HR[95%CI]: 2.52[1.02-6.23], p = 0.045) and (borderline) in SAP patients (HR[95%CI]: 8.48[0.92-78.0], p = 0.058). In ACS patients, this association lost statistical significance after multivariable adjustment (HR[95%CI]: 1.87[0.67-5.19], p = 0.23). CONCLUSION:In the full cohort, adiponectin levels were associated with death but not with VH-IVUS atherosclerosis measures. In SAP patients, adiponectin levels were associated with VH-IVUS-derived TCFA lesions. Altogether, substantial role for adiponectin in plaque vulnerability remains unconfirmed.

Project description:This study aimed to evaluate the relationship between cigarette smoking and coronary atherosclerotic burden, volume and composition as determined in-vivo by grayscale and virtual histology (VH) intravascular ultrasound (IVUS).Between 2008 and 2011, (VH-)IVUS of a non-culprit coronary artery was performed in 581 patients undergoing coronary angiography. To account for differences in baseline characteristics, current smokers were matched to never smokers by age, gender and indication for catheterization, resulting in 280 patients available for further analysis. Coronary atherosclerotic plaque volume, burden, composition (fibrous, fibro-fatty, dense calcium and necrotic core) and high-risk lesions (VH-IVUS derived thin-cap fibroatheroma (TCFA), plaque burden ?70%, minimal luminal area ?4.0 mm2) were assessed. Cigarette smoking showed a tendency towards higher coronary plaque burden (mean±SD, 38.6±12.5% in current versus 36.4±11.0% in never smokers, p = 0.080; and odds ratio (OR) of current smoking for plaque burden above versus below the median 1.69 (1.04-2.75), p = 0.033). This effect was driven by an association in patients presenting with an acute coronary syndrome (ACS) (current smokers, plaque burden 38.3±12.8% versus never smokers, plaque burden 35.0±11.2%, p = 0.049; OR 1.88 (1.02-3.44), p = 0.042). Fibrous tissue tended to be lower in current smokers (mean±SD, 57.7±10.5% versus 60.4±12.6%, p = 0.050) and fibro-fatty tissue was higher in current smokers (median[IQR], 9.6[6.0-13.7]% versus 8.6[5.8-12.2]%, p = 0.039). However, differences in percentage necrotic core and dense calcium could not be demonstrated. Also, no differences were found with regard to high-risk lesions.An association between smoking and degree of coronary atherosclerosis was present in patients undergoing coronary angiography who presented with ACS. Although smoking was associated with higher fibro-fatty percentage, no associations could be demonstrated with percentage necrotic core, nor with VH-IVUS derived TCFA lesions. Since the magnitude of the differences in both degree and composition of atherosclerosis was modest, clinical relevance of the findings may be questioned.

Dataset Information

Culprit Plaque Characteristics in Patients With Sleep-Disordered Breathing Undergoing Percutaneous Coronary Intervention: An Intravascular Ultrasound Study.

Publications

Culprit Plaque Characteristics in Patients With Sleep-Disordered Breathing Undergoing Percutaneous Coronary Intervention: An Intravascular Ultrasound Study.

Similar Datasets

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