Introduction
Patients and methods
Patients and study design
PCI strategy and antiplatelet therapy
Angiographic analyses
Intravascular ultrasound examination and analysis
CT protocol
Measurement of EATV
Statistical methods
Ethical considerations
Results
High- and low-EATV groups
Clinical characteristics | Low-EATV group | High-EATV group |
P value |
---|---|---|---|
No. of patients | 65 | 65 | |
Age (years) | 67.7 ± 10.1 | 68.0 ± 9.0 | 0.83 |
Height (cm) | 161.6 ± 9.8 | 161.1 ± 9.4 | 0.78 |
Body weight (kg) | 62.1 ± 11.6 | 61.7 ± 9.8 | 0.83 |
BMI (kg/m2) | 23.6 ± 2.9 | 23.7 ± 2.8 | 0.89 |
Male gender | 53 (81.5) | 45 (69.2) | 0.10 |
Risk factors | |||
Family history | 24 (36.9) | 21 (32.3) | 0.58 |
Hypertension | 47 (72.3) | 42 (64.6) | 0.35 |
Dyslipidemia | 45 (69.2) | 41 (63.1) | 0.46 |
Current smoker | 18 (27.7) | 12 (18.5) | 0.21 |
Diabetes mellitus | 19 (29.2) | 24 (36.9) | 0.35 |
Total cholesterol (mg/dl) | 181.0 ± 37.5 | 186.7 ± 39.7 | 0.43 |
LDL cholesterol (mg/dl) | 99.1 ± 30.6 | 105.7 ± 32.9 | 0.25 |
HDL cholesterol (mg/dl) | 48.1 ± 12.3 | 46.0 ± 14.3 | 0.38 |
Triglycerides (mg/dl) | 162.5 ± 110.7 | 146.6 ± 100.1 | 0.41 |
ApoB/A1 ratio | 0.81 ± 0.32 | 0.87 ± 0.26 | 0.44 |
EPA/AA ratio | 0.56 ± 0.42 | 0.58 ± 0.50 | 0.77 |
HbA1c (NGSP) | 6.22 ± 1.01 | 6.47 ± 1.25 | 0.24 |
Cr (mg/dl) | 0.93 ± 0.16 | 0.95 ± 0.18 | 0.93 |
Cystatin C (mg/l) | 1.34 ± 0.24 | 1.39 ± 0.26 | 0.89 |
hs-CRP (mg/dl) | 0.12 ± 0.18 | 0.29 ± 0.21 | 0.19 |
CAC score | 152.3 ± 86.4 | 188.6 ± 92.2 | 0.17 |
Medications | |||
ARB | 23 (35.4) | 20 (30.8) | 0.58 |
CCB | 29 (44.6) | 34 (52.3) | 0.38 |
Statin | 25 (38.5) | 40 (61.5) | 0.01 |
EPA | 6 (9.2) | 5 (7.7) | 0.75 |
Angiographic findings | Low-EATV group | High-EATV group |
P value |
---|---|---|---|
Pre MLD (mm) | 1.11 ± 0.35 | 1.19 ± 0.41 | 0.22 |
Pre diameter stenosis (%) | 60.5 ± 12.5 | 57.4 ± 13.6 | 0.17 |
Pre reference diameter (mm) | 2.87 ± 0.71 | 2.92 ± 0.73 | 0.64 |
Lesion length (mm) | 24.2 ± 13.4 | 24.4 ± 11.4 | 0.93 |
Post MLD (mm) | 2.64 ± 0.60 | 2.68 ± 0.69 | 0.71 |
Post diameter stenosis (%) | 12.7 ± 7.9 | 13.5 ± 7.8 | 0.55 |
Diseased vessel (%) | 0.83 | ||
Left main artery | 1 (1.5) | 1 (1.5) | |
Left anterior descending artery | |||
Proximal | 18 (36.9) | 22 (49.2) | |
Mid | 5 (7.7) | 8 (12.3) | |
Distal | 1 (1.5) | 2 (3.1) | |
Left circumflex artery | |||
Proximal | 8 (8.1) | 4 (6.2) | |
Mid | 4 (6.2) | 4 (6.2) | |
Distal | 5 (7.7) | 4 (6.2) | |
Right coronary artery | |||
Proximal | 7 (10.8) | 8 (12.3) | |
Mid | 7 (10.8) | 8 (12.3) | |
Distal | 9 (13.8) | 4 (6.2) | |
CT findings | |||
Average no. of plaques | 2.2 ± 0.6 | 2.8 ± 0.8 | 0.11 |
No. of stenoses | 0.49 | ||
50–75 % | 21 (32.3) | 17 (26.2) | |
More than 75 % | 44 (67.7) | 48 (73.8) | |
Plaque characteristics | 0.93 | ||
Noncalcified | 40 (61.5) | 38 (58.5) | |
Mixed | 23 (35.4) | 25 (38.5) | |
Calcified | 2 (3.1) | 2 (3.1) | |
CAC score | 64.7 ± 58.4 | 98.6 ± 66.5 | 0.16 |
IVUS findings | Low-EATV group | High-EATV group |
P value |
---|---|---|---|
Vessel volume (mm3) | 126.6 ± 44.5 | 144.6 ± 53.7 | 0.04 |
Luminal volume (mm3) | 49.9 ± 19.3 | 50.6 ± 20.2 | 0.84 |
Minimum luminal area (mm2) | 2.99 ± 1.14 | 2.98 ± 1.01 | 0.95 |
Reference area at MLA (mm2) | 12.02 ± 4.46 | 13.80 ± 5.38 | 0.04 |
Area stenosis at MLA (mm2) | 72.9 ± 10.2 | 76.5 ± 8.3 | 0.03 |
Lesion length (mm) | 9.9 ± 0.6 | 9.9 ± 0.7 | 0.55 |
Remodeling index | 0.87 ± 0.14 | 1.04 ± 0.16 | 0.07 |
Plaque volume (mm3) | 76.7 ± 32.2 | 93.9 ± 41.6 | 0.01 |
Fibrous (mm3) | 42.8 ± 16.4 | 39.2 ± 15.5 | 0.19 |
Lipid (mm3) | 6.0 ± 3.7 | 7.9 ± 4.2 | 0.01 |
Necrotic (mm3) | 13.6 ± 8.4 | 22.8 ± 12.2 | <0.01 |
Calcified (mm3) | 1.9 ± 1.3 | 3.7 ± 2.3 | <0.01 |
Unknown (mm3) | 7.5 ± 9.6 | 14.3 ± 13.2 | 0.00 |
Masked (mm3) | 5.22 ± 4.3 | 6.6 ± 4.4 | 0.07 |
Fibrous (%) | 58.6 ± 14.1 | 43.4 ± 11.0 | <0.01 |
Lipid (%) | 7.4 ± 2.4 | 8.3 ± 2.3 | 0.03 |
Necrotic (%) | 16.7 ± 5.7 | 23.7 ± 4.8 | <0.01 |
Calcified (%) | 2.8 ± 2.1 | 4.3 ± 2.7 | <0.01 |
Univariate analysis | Multivariate analysis | |||
---|---|---|---|---|
R
2
|
P
|
β
|
P
| |
(A) | ||||
HbA1c
| 0.18 | 0.16 | ||
LDL cholesterol | 0.38 | <0.01 | 0.15 | 0.03 |
HDL cholesterol | 0.14 | 0.83 | ||
EPA/AA ratio | 0.08 | 0.39 | ||
hs-CRP | 0.09 | 0.15 | ||
EATV | 0.34 | <0.01 | 0.14 | 0.02 |
BMI | 0.10 | 0.43 | ||
Smoking | 0.16 | 0.55 | ||
(B) | ||||
HbA1c
| 0.16 | 0.61 | ||
LDL cholesterol | 0.27 | 0.04 | 0.10 | 0.04 |
HDL cholesterol | 0.06 | 0.12 | ||
EPA/AA ratio | 0.09 | 0.77 | ||
hs-CRP | 0.09 | 0.15 | ||
BMI | 0.18 | 0.43 | ||
Smoking | 0.03 | 0.22 |