背景:富含脂质的斑块(LRP)研究确定了冠状动脉中大量脂质含量(最大脂质核心负担指数[maxLCBI4mm]>400)与随后的非罪犯主要不良心脏事件(NC-MACE)之间的关联。该分析试图评估冠状动脉树中一个以上富含脂质的斑块的临床影响。
方法:将LRP患者人群分为四个队列:1)所有节段的maxLCBI4mm=0的患者;2)所有冠状动脉节段的maxLCBI4mm<400但>0的患者;3)1节段的maxLCBI4mm>400的患者;4)2个冠状动脉节段的maxLCBI4mm>400的患者。基线特征,斑块级特征,并描述了随访结果.
结果:在1550名患者中,只有3.2%的所有节段maxLCBI4mm=0;65.1%的节段maxLCBI4mm>0但<400;22.5%的节段有一个节段maxLCBI4mm>400;9.5%的节段有2+冠状动脉节段,maxLCBI4mm>400。冠状动脉树中的分布(一条动脉与多条动脉)没有差异。总的来说,1269名患者被分配到随访(根据研究设计)。全因死亡的复合物,心脏死亡,任何血运重建,在1段maxLCBI4mm>400的患者中,NC-MACE在统计学上较高,在2段maxLCBI4mm>400的患者中,NC-MACE在数值上甚至更高。maxLCBI4mm=0的患者在两年内没有事件。
结论:全因死亡的风险逐步增加,心脏死亡,任何血运重建,根据maxLCBI4mm>400的冠状动脉节段数进行NC-MACE。相比之下,maxLCBI4mm=0导致低事件率。
背景:富含脂质的斑块研究(LRP),https://clinicaltrials.gov/ct2/show/NCT02033694,NCT02033694.
The Lipid Rich Plaque (LRP)
Study established the association between high volume of lipidic content (maximum Lipid Core Burden Index [maxLCBI4mm] >400) in the coronary arteries and subsequent non-culprit major adverse cardiac events (NC-MACE). This analysis sought to assess the clinical impact of more than one lipid-rich plaque in the coronary tree.
The LRP patient population was divided into four cohorts: 1) patients with all segments with maxLCBI4mm = 0; 2) patients with all coronary segments maxLCBI4mm < 400, but >0; 3) patients with 1 segment maxLCBI4mm > 400; and 4) patients with 2+ coronary segments with maxLCBI4mm > 400. Baseline characteristics, plaque-level characteristics, and follow-up outcomes were described.
Among 1550 patients, only 3.2 % had all segments with maxLCBI4mm = 0; 65.1 % had segments with maxLCBI4mm > 0 but <400; 22.5 % had one segment with maxLCBI4mm > 400; and 9.5 % had 2+ coronary segments with maxLCBI4mm > 400. Distribution within the coronary tree (one versus multiple arteries) did not differ. Overall, 1269 patients were allocated to follow-up (per
study design). The composite of all-cause death, cardiac death, any revascularization, and NC-MACE was statistically higher in patients with 1 segment maxLCBI4mm > 400 and numerically even higher in patients with 2+ segments with maxLCBI4mm > 400. Patients with maxLCBI4mm = 0 had no events within two years.
There is a stepwise increased risk of all-cause death, cardiac death, any revascularization, and NC-MACE according to the number of coronary segments with maxLCBI4mm > 400. In contrast, maxLCBI4mm = 0 results in a low event rate.
The Lipid-Rich Plaque
Study (LRP), https://clinicaltrials.gov/ct2/show/NCT02033694, NCT02033694.