Clinical research in cardiology : official journal of the German Cardiac Society · 2025
Prognostic value of SYNTAX score, intravascular ultrasound and near-infrared spectroscopy in coronary disease: 12-year follow-up of ATHEROREMO.
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Meuleman Victor G, Vanmaele Alexander, Da Veiga Fernandes de Mira Jose M, Akkerhuis K Martijn, Oemrawsingh Rohit M, Vroegindewey Maxime M, Cheng Jin M, Garcia-Garcia Hector M, Daemen Joost, van Mieghem Nicolas M, Serruys Patrick W, van Geuns Robert Jan, Boersma Eric, Kardys Isabella
Аннотация
BACKGROUND AND AIMS: This study aims to investigate the very long-term predictive value of the SYNTAX score and plaque characteristics derived by intravascular ultrasound (IVUS) as well as near-infrared spectroscopy (NIRS), for all-cause mortality in patients with low to intermediate complex coronary artery disease.
METHODS: We evaluated 581 patients with chronic or acute coronary syndrome from the European Collaborative Project on Inflammation and Vascular Wall Remodeling in Atherosclerosis (ATHEROREMO) cohort. Flow-limiting lesions were treated with intracoronary stenting. IVUS-VH (n = 581) and NIRS (n = 195) images were obtained in a non-culprit segment ≥ 40 mm. Cox models were applied to relate pre-PCI SYNTAX score and plaque characteristics to very long-term all-cause mortality. Adjusted hazard ratios (aHR), corrected for cardiovascular comorbidities and risk factors, are reported per doubling of the corresponding variable.
RESULTS: Mean (standard deviation) age was 62 (11) years; 76% were men; median SYNTAX score was 9.0 (25th-75th percentile 4.0-15.0). Median follow-up was 12.8 (25th-75th percentile 10.1-13.4) years, and 177 cases of all-cause mortality occurred. SYNTAX score (aHR 1.25, 95% confidence interval [CI] 1.05-1.48; p = 0.012) and percentage dense calcified plaque (aHR 1.21 [1.02-1.42]; p = 0.026) were associated with increased mortality risk, while fibrous plaque (aHR 0.54 [0.34-0.87]; p = 0.011) was related to reduced risk. NIRS features were not associated with very long-term mortality.
CONCLUSION: Angiography-based SYNTAX score and IVUS-VH-defined fibrous and dense calcified plaque were related to 12-year mortality in patients with low-to-intermediate complex CAD.
METHODS: We evaluated 581 patients with chronic or acute coronary syndrome from the European Collaborative Project on Inflammation and Vascular Wall Remodeling in Atherosclerosis (ATHEROREMO) cohort. Flow-limiting lesions were treated with intracoronary stenting. IVUS-VH (n = 581) and NIRS (n = 195) images were obtained in a non-culprit segment ≥ 40 mm. Cox models were applied to relate pre-PCI SYNTAX score and plaque characteristics to very long-term all-cause mortality. Adjusted hazard ratios (aHR), corrected for cardiovascular comorbidities and risk factors, are reported per doubling of the corresponding variable.
RESULTS: Mean (standard deviation) age was 62 (11) years; 76% were men; median SYNTAX score was 9.0 (25th-75th percentile 4.0-15.0). Median follow-up was 12.8 (25th-75th percentile 10.1-13.4) years, and 177 cases of all-cause mortality occurred. SYNTAX score (aHR 1.25, 95% confidence interval [CI] 1.05-1.48; p = 0.012) and percentage dense calcified plaque (aHR 1.21 [1.02-1.42]; p = 0.026) were associated with increased mortality risk, while fibrous plaque (aHR 0.54 [0.34-0.87]; p = 0.011) was related to reduced risk. NIRS features were not associated with very long-term mortality.
CONCLUSION: Angiography-based SYNTAX score and IVUS-VH-defined fibrous and dense calcified plaque were related to 12-year mortality in patients with low-to-intermediate complex CAD.
Предметные рубрики MeSH
AgedFemaleHumansMaleMiddle AgedCoronary AngiographyCoronary Artery DiseaseCoronary VesselsEuropeFollow-Up StudiesPercutaneous Coronary InterventionPlaque, AtheroscleroticPredictive Value of TestsPrognosisRisk FactorsSeverity of Illness IndexSpectroscopy, Near-InfraredTime FactorsUltrasonography, Interventional