Clinical Course of Optical Coherence Tomography-Detected Lipid-Rich Coronary Plaque After Optimal Medical Therapy

• 資料種別: 博士論文
• タイトル: Clinical Course of Optical Coherence Tomography-Detected Lipid-Rich Coronary Plaque After Optimal Medical Therapy
• 著者・編者: Sugiura, Junichi; Soeda, Tsunenari; Kyodo, Atsushi; Nakamura, Takuya; Okamura, Akihiko; Nogi, Kazutaka; Hashimoto, Yukihiro; Ueda, Tomoya; Watanabe, Makoto; Saito, Yoshihiko
• 著者標目: Sugiura, Junichi; Soeda, Tsunenari; Kyodo, Atsushi; Nakamura, Takuya; Okamura, Akihiko; Nogi, Kazutaka; Hashimoto, Yukihiro; Ueda, Tomoya; Watanabe, Makoto; Saito, Yoshihiko
• 出版事項: Japanese Circulation Society
• 出版年月日等: 2021-12-03
• 出版年（W3CDTF）: 2021-12-03
• 並列タイトル等: OCT で検出された冠動脈のlipid-richプラークに対する至適薬物療法施行後の臨床経過
• タイトル（掲載誌）: Circulation reports
• 巻号年月日等（掲載誌）: 4 1
• 掲載巻: 4
• 掲載号: 1
• 掲載ページ: 29-37
• ISSN（掲載誌）: ISSN : 2434-0790
• 授与機関名: 奈良県立医科大学
• 授与年月日: 2023-03-15
• 報告番号: 甲第869号
• 学位: 博士（医学）
• 本文の言語コード: eng
• 件名標目: Coronary computed tomography; High-risk plaque feature; Lipid rich coronary plaque; Optical coherence tomography; Optimal medical therapy
• 対象利用者: 一般
• 一般注記: type:Thesis; Background: The aim of this study was to evaluate optical coherence tomography (OCT)-detected lipid-rich coronary plaques (LRCPs) with coronary computed tomography angiography (CCTA) 10 months after optimal medical therapy (OMT). Methods and Results: Baseline OCT detected 28 LRCPs in non-culprit lesions. High-risk plaque features (HRPFs), such as positive remodeling, very low attenuation plaques, napkin-ring sign, and spotty calcification, were observed in 67.9%, 67.9%, 21.4%, and 64.3% of LRCPs, respectively, at the 10-month follow-up CCTA. Lesions with ≥3 HRPFs were defined as high-risk LRCPs (n=12); the remaining were defined as low-risk LRCPs (n=16). The maximum lipid arc on baseline OCT was larger in high- than low-risk LRCPs (221±62° vs. 179±44°, respectively; P=0.04). Receiver operating characteristic curve analysis indicated that a maximum lipid arc >154° on baseline OCT was the optimal cut-off value to predict high-risk LRCPs 10 months after OMT. Patients with high-risk LRCPs had worse clinical outcomes, defined as a composite of cardiac death, target lesion-related myocardial infarction, and target lesion-related revascularization, during follow-up than those with low-risk LRCPs (33.3% vs. 0%; P=0.01). Conclusions: A high-risk LRCP at follow-up CCTA was correlated with a larger maximum lipid arc on baseline OCT. Further aggressive treatment for patients with large LRCPs may reduce vulnerable plaque features and prevent future cardiac events.; 博士（医学）・甲第869号・令和5年3月15日; © 2022, THE JAPANESE CIRCULATION SOCIETY This article is licensed under a Creative Commons [Attribution-NonCommercial-NoDerivatives 4.0 International] license.; identifier:Circulation reports Vol.4 No.1 p.29-37 (2021 Dec); identifier:24340790; identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/4101; identifier:Circulation reports, 4(1): 29-37
• 一次資料へのリンクURL: fulltext; http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/4101/1/01%e7%94%b2869%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdf; http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/4101/2/02%e7%94%b2869%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdf; http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/4101/6/03%e7%94%b2869%e6%9c%ac%e6%96%87.pdf
• オンライン閲覧公開範囲: インターネット公開
• 関連情報（DOI）: 10.1253/circrep.CR-21-0147
• 連携機関・データベース: 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• 提供元機関・データベース: 奈良県立医科大学 : 奈良県立医科大学機関リポジトリ GINMU