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Differences in coronary plaque characteristics between patients with and those without peripheral arterial disease.
- Source :
-
Coronary artery disease [Coron Artery Dis] 2017 Dec; Vol. 28 (8), pp. 658-663. - Publication Year :
- 2017
-
Abstract
- Introduction: Cardiovascular mortality of patients with combined peripheral arterial disease (PAD) and coronary artery disease (CAD) is twice as high as that in those with either disease alone. It is known that patients with PAD undergoing percutaneous coronary intervention have a higher incidence of adverse cardiac events such as myocardial infarction or target vessel revascularization.<br />Objective: In this study, we compared the detailed characteristics of culprit and nonculprit plaques between patients with and those without PAD using optical coherence tomography.<br />Patients and Methods: We performed propensity score matching using the following variables: (i) age; (ii) sex; (iii) clinical presentation; (iv) diabetes mellitus; (v) hyperlipidemia; (vi) smoking; (vii) hypertension; (viii) BMI; and (ix) coronary lesion location. Finally, we matched 34 culprit lesions and 30 nonculprit lesions in patients with PAD to 68 culprit lesions and 60 nonculprit lesions in patients without PAD (1 : 2 ratio).<br />Results: In culprit lesions, PAD patients when compared with those without PAD had a higher prevalence of lipid-rich plaque (73.5 vs. 51.5%; P=0.033), higher lipid index (1744±1110 vs. 1246±656; P=0.043), calcification (79.4 vs. 58.8%; P=0.039), macrophage accumulation (70.6 vs. 48.5%; P=0.034), and cholesterol crystals (32.4 vs. 10.3%; P=0.006). In nonculprit lesions, PAD patients had a higher prevalence of calcification (76.7 vs. 55.0%; P=0.046), macrophage accumulation (63.3 vs. 38.3%; P=0.025), and cholesterol crystals (36.7 vs. 16.7%; P=0.034).<br />Conclusion: Our study suggests greater coronary plaque vulnerability in both culprit and nonculprit lesions in patients with PAD. This observation underscores the need for more aggressive risk management in patients with combined PAD and coronary artery disease.
- Subjects :
- Aged
Chi-Square Distribution
Cholesterol analysis
Coronary Artery Disease complications
Coronary Artery Disease pathology
Coronary Vessels chemistry
Coronary Vessels pathology
Crystallization
Female
Humans
Macrophages pathology
Male
Middle Aged
Peripheral Arterial Disease diagnosis
Predictive Value of Tests
Prognosis
Propensity Score
Registries
Retrospective Studies
Risk Factors
Vascular Calcification complications
Vascular Calcification pathology
Coronary Artery Disease diagnostic imaging
Coronary Vessels diagnostic imaging
Peripheral Arterial Disease complications
Plaque, Atherosclerotic
Tomography, Optical Coherence
Vascular Calcification diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1473-5830
- Volume :
- 28
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Coronary artery disease
- Publication Type :
- Academic Journal
- Accession number :
- 28692481
- Full Text :
- https://doi.org/10.1097/MCA.0000000000000531