δείτε την πρωτότυπη σελίδα τεκμηρίου στον ιστότοπο του αποθετηρίου του φορέα για περισσότερες πληροφορίες και για να δείτε όλα τα ψηφιακά αρχεία του τεκμηρίου*
Prevalence and predictors of culprit plaque rupture at OCT in patients
with coronary artery disease: a meta-analysis
Iannaccone, Mario
Quadri, Giorgio
Taha, Salma
D'Ascenzo,
Fabrizio
Montefusco, Antonio
Omede', Pierluigi
Jang,
Ik-Kyung
Niccoli, Giampaolo
Souteyrand, Geraud
Chen Yundai
and Toutouzas, Konstantinos
Benedetto, Sara
Barbero, Umberto and
Annone, Umberto
Lonni, Enrica
Imori, Yoichi
Biondi-Zoccai,
Giuseppe
Templin, Christian
Moretti, Claudio
Luscher, Thomas
F.
Gaita, Fiorenzo
Aims The prevalence of plaque rupture at the culprit lesion identified
by optical coherence tomography (OCT) in different clinical subset of
patients undergoing coronary angiography and its clinical predictors
remain to be defined.
Methods All studies including patients with OCT evaluation of the
culprit coronary plaque were included. The prevalence of culprit plaque
rupture (CPR) and thin-cap fibro-atheroma (TCFA) were the primary
endpoints. The factors associated with these findings were studied in a
subset of patients with different clinical presentations [ST-elevation
myocardial (STEMI) vs. nonST-elevation myocardial infarction (NSTEMI)
vs. unstable angina (UA) vs. stable angina pectoris (SAP)].
Results One hundred and fifty citations were initially appraised at the
abstract level and 23 full-text studies were assessed. The mean
prevalence of CPR and TCFA was 48.1% (40.5-55.8) and 48.7%
(37.4-60.1), respectively. The prevalence of CPR and TCFA were higher in
STEMI (70.4 and 76.6%) than in NSTEMI (55.6 and 56.3%) and UA (39.1
and 52.9%) or SAP (6.2 and 22.8%). In the overall population at
meta-regression analysis, TCFA and current smoking were the only
predictors of CPR (B 3.6:2.0-5.1, P < 0.001 and 0.06:0.02-0.1, P =
0.002, respectively). The factors associated with CPR were different
depending on clinical presentation. Hypertension was the only clinical
predictor for STEMI (B 3.3:1.2.-5.3 P = 0.001), while advanced age (B
0.12:0.02-0.22, P = 0.021), diabetes mellitus (B 0.04:0.01-0.08, P =
0.012), and hyperlipidaemia (B 0.07:0.02-0.11, P = 0.005) were the
predictors in NSTEMI and UA. No clinical predictor was found in SA.
Conclusions Our analysis showed high rates of CPR and TCFA detected by
OCT in CAD patients, especially in those with ACS, although their
prevalence is not negligible in stable patients. TCFA seems to be a
strong predictor of CPR in all the ACS scenarios.
(EN)
*Η εύρυθμη και αδιάλειπτη λειτουργία των διαδικτυακών διευθύνσεων των συλλογών (ψηφιακό αρχείο, καρτέλα τεκμηρίου στο αποθετήριο) είναι αποκλειστική ευθύνη των αντίστοιχων Φορέων περιεχομένου.
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