Age and phenotype of patients with plaque erosion

Makoto Araki, Taishi Yonetsu, Osamu Kurihara, Akihiro Nakajima, Hang Lee, Tsunenari Soeda, Yoshiyasu Minami, Takumi Higuma, Shigeki Kimura, Masamichi Takano, Bryan P. Yan, Tom Adriaenssens, Niklas F. Boeder, Holger M. Nef, Chong Jin Kim, Iris McNulty, Filippo Crea, Tsunekazu Kakuta, Ik Kyung Jang

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: A recent study reported that the outcome of patients with plaque erosion treated with stenting is poor when the underlying plaque is lipid rich. However, the detailed phenotype of patients with plaque erosion, particularly as related to different age groups, has not been systematically studied. METHODS AND RESULTS: Patients with acute coronary syndromes caused by plaque erosion were selected from 2 data sets. Demographic, clinical, angiographic, and optical coherence tomography findings of the culprit lesion were compared between 5 age groups. Among 579 erosion patients, male sex and current smoking were less frequent, and hypertension, diabetes, and chronic kidney disease were more frequent in older patients. ST-segment–elevation myocardial infarction was more frequent in younger patients. Percentage of diameter stenosis on angiogram was greater in older patients. The prevalence of lipid-rich plaque (27.3% in age <45 years and 49.4% in age ≥75 years, P<0.001), cholesterol crystal (3.9% in age <45 years and 21.8% in age ≥75 years, P=0.027), and calcification (5.5% in age <45 years and 54.0% in age ≥75 years, P<0.001) increased with age. After adjusting risk factors, younger patients were associated with the presence of thrombus, and older patients were associated with greater percentage of diameter stenosis and the presence of lipid-rich plaque and calcification. CONCLUSIONS: The demographic, clinical, angiographic, and plaque phenotypes of patients with plaque erosion distinctly vary depending on age. This may affect the clinical outcome in these patients. REGISTRATION: URL: https://www.clini​caltr​ials.gov. Unique identifiers: NCT03479723, NCT02041650.

Original languageEnglish
Article numbere020691
JournalJournal of the American Heart Association
Volume10
Issue number19
DOIs
Publication statusPublished - Oct 5 2021

Keywords

  • Acute coronary syndrome
  • Age
  • Cholesterol crystal
  • Lipid-rich plaque
  • Plaque erosion

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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