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ȣ - 530011 58 |
Age-Related Differences in Virtual Histology-Intravascular Ultrasound Findings in Patients with Coronary Artery Disease |
전남대학교병원 심장센터, 보건복지가족부 지정 심장질환 특성화 연구센터 |
홍영준, 정명호, 최윤하, 마은혜, 고점석, 이민구, 박근호, 심두선, 윤남식, 윤현주, 김계훈, 박형욱, 김주한, 안영근, 조정관, 박종춘, 강정채 |
BACKGROUND: The characteristics of plaque components according to aging process are not well known.
OBJECTIVES: We assessed the age-related differences in pre-intervention virtual histology-intravascular ultrasound (VH-IVUS) findings at target lesion sites in patients with coronary artery disease.
METHODS: A total of 553 patients who underwent pre-intervention VH-IVUS imaging were grouped according to age: non-elderly (≤70 years, n=429) and elderly (> 70 years, n=124). VH-IVUS classified the color-coded tissue into four major components: fibrotic, fibro-fatty, dense calcium (DC), and necrotic core (NC). Thin-cap fibroatheroma (TCFA) was defined as focal, NC-rich (≥ 10% of the cross-sectional area) plaques being in contact with the lumen in a plaque burden ≥ 40%.
RESULTS: Proximal and distal reference segment plaque burdens were significantly greater in elderly group (39±8 mm2 vs. 37±8 mm2, p=0.042, and 38±7 mm2 vs. 36±8 mm2, p=0.048, respectively). The absolute and percent areas of DC (0.67±0.62 mm2 vs. 0.57±0.57 mm2, p=0.032, 11.8±10.9% vs. 9.9±9.6%, p=0.039, respectively) and NC (1.29±1.17 mm2 vs. 1.14±0.97 mm2, p=0.014, 20.8±11.8% vs. 18.1±11.6%, p=0.023, respectively) at the minimum lumen site were significantly greater in elderly group. The absolute and percent volumes of DC (11.0±11.0 mm3 vs. 9.7±11.9 mm3, p=0.033, 11.7±8.1% vs. 9.8±7.2%, p=0.014, respectively) and NC (18.5±17.6 mm3 vs. 16.6±18.9 mm3, p=0.020, 18.8±8.8% vs. 16.5±9.3%, p=0.026, respectively) were significantly greater in elderly group. There was a trend towards higher incidence of TCFA in elderly group (65% vs. 56%, p=0.089).
CONCLUSIONS: VH-IVUS analysis demonstrates that elderly patients have more NC and DC-containing plaques compared with younger patients. This may be associated with poorer outcome in elderly patients compared with younger patients.
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