Optical coherence tomography reveals age-specific plaque vulnerabilities in STEMI patients

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Announcing the publication of a new article for Cardiovascular Innovations and Applications Journal

Age-related attenuation of pancoronary plaques in patients with ST-segment elevation myocardial infarction (STEMI) has not been systematically assessed by optical coherence tomography (OCT). The authors of this article explore the differences in pancoronary characteristics between young and elderly patients with STEMI by OCT.

This retrospective single-center study included 588 patients who had STEMI and underwent three-vessel OCT with emergency percutaneous coronary intervention between October 2016 and September 2018. With an age of 56 years as a cutoff, patients were divided into a younger group (≤56 years, n = 298) and an older group (>56 years, n = 290).

795 non-culprit plaques were found in 298 young patients, whereas 858 non-culprit plaques were detected in 290 elderly patients. Fewer high-risk OCT plaques (15.8% vs. 23.1%; P = 0.025), as well as other structures (cholesterol crystals, P = 0.001; microchannels, P = 0.032; calcification, P < 0.001; large calcification, speckled < 0.01, P = 0.01). <0.001; and thrombi, P = 0.001) at the patient level were detected in younger patients compared to older patients. Additionally, pancoronary impairment in younger patients was independently predicted by culprit plaque rupture {CLIMA-defined high-risk plaque (odds ratio) [OR]: 3.179; 95% CI: 1.501 to 6.733; P = 0.003), non-culprit rupture (OR: 3.802; 95% CI: 1.604 to 9.014; P = 0.002), non-culprit thin-cap fibrotheroma (OR: 3.536; 95% CI: 2.051 to

Among STEMI patients, younger patients had limited vulnerable plaque characteristics, and pancoronary vulnerability was associated with culprit plaque rupture, hypertension, and total cholesterol. In contrast, older patients had greater pancoronary vulnerability with a single predictor of male gender, thus suggesting that traditional risk factors have limited applicability in predicting pancoronary vulnerability in elderly patients.

Source:

Journal Reference:

Wu, T. etc. (2024). Age-related pancoronary characteristics in patients with ST-segment elevation myocardial infarction. Cardiovascular Innovations and Applications. doi.org/10.15212/cvia.2023.0082.



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