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29.05.2017 | Original Paper | Ausgabe 10/2017

The International Journal of Cardiovascular Imaging 10/2017

Plaque characteristics and inflammatory markers for the prediction of major cardiovascular events in patients with ST-segment elevation myocardial infarction

Zeitschrift:
The International Journal of Cardiovascular Imaging > Ausgabe 10/2017
Autoren:
Ae-Young Her, Kyoung Im Cho, Gillian Balbir Singh, Dae Seong An, Young-Hoon Jeong, Bon-Kwon Koo, Eun-Seok Shin
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1007/​s10554-017-1135-x) contains supplementary material, which is available to authorized users.
Ae-Young Her and Kyoung Im Cho equally contributed to this article as first author.

Abstract

To investigate the clinical utility of culprit plaque characteristics and inflammatory markers for the prediction of future cardiovascular events in patients with ST-segment elevation myocardial infarction (STEMI) with successful drug-eluting stent (DES) implantation. We evaluated 172 STEMI patients with successful primary percutaneous coronary intervention (PCI) with DES using pre-PCI high-sensitivity C-reactive protein (hs-CRP), neutrophil-to-lymphocyte ratio (NLR) and pre-PCI intravascular ultrasound virtual histology (IVUS-VH) of culprit lesions. The incidence of major adverse cardiovascular events (MACE) including all-cause mortality, non-fatal MI, stroke and late revascularization were recorded during hospitalization and follow-up. During follow-up (median 41 months), the incidence of MACE did not significantly differ among patients with or without all 3 high-risk plaque features on IVUS-VH (15.1 vs. 16.2%; p = 0.39). In contrast, patients with elevated hs-CRP and NLR levels were at significant risk for MACE [32.7 vs. 5.8%; hazard ratio (HR) 7.85; p < 0.001 and 43.9 vs. 6.9%; HR 8.44; p < 0.001, respectively]. High-risk plaque features had no incremental usefulness to predict future MACE. However, the incorporation of hs-CRP and NLR into a model with conventional clinical and procedural risk factors significantly improved the C-statistic for the prediction of MACE (0.76–0.89; p = 0.04). High-risk plaque features identified by IVUS-VH in culprit lesions were not associated with future MACE in patients with STEMI receiving DES. However, elevated hs-CRP and NLR levels were significantly associated with poorer outcomes and had incremental predictive values over conventional risk factors.

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Supplementary material 1 (DOCX 14 KB)
10554_2017_1135_MOESM1_ESM.docx
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