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
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 positiveremodeling, very low attenuation plaques, napkin-ring sign, and spotty calcification, were observed in 67.9%, 67.9%, 21.4%, and64.3% 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-riskLRCPs (221±62° vs. 179±44°, respectively; P=0.04). Receiver operating characteristic curve analysis indicated that a maximum lipidarc >154° on baseline OCT was the optimal cut-off value to predict high-risk LRCPs 10 months after OMT. Patients with high-riskLRCPs had worse clinical outcomes, defined as a composite of cardiac death, target lesion-related myocardial infarction, and targetlesion-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. Furtheraggressive 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 SOCIETYThis 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
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