Abstract 907: Plaque Burden at Left Main Coronary Artery of Patients Undergoing Percutaneous Coronary Intervention with Metabolic Syndrome

Abstract

Background: The left main coronary artery (LMCA) is an important target of atherosclerotic plaque accumulation. The purpose of this study is to investigate the relationship between metabolic syndrome and plaque characteristics at LMCA. Methods: We enrolled 63 consecutive patients with stable angina who underwent percutaneous coronary intervention (PCI). Using intravascular ultrasound (IVUS), cross-sectional area (CSA), lumen area and plaque area were checked at LMCA undergoing PCI for the left anterior descending coronary artery or left circumflex coronary artery but not LMCA. Total plaque volume at LMCA was also checked by IVUS. The tissue characteristics of coronary plaque at LMCA was analyzed and quantified using integrated backscatter (IB) IVUS. The patients were devided into the two groups who had metabolic syndrome (n = 34) or not (n = 39). We evaluated the relationship between plaque burden at LMCA and metabolic syndrome. Results: Patients with metabolic syndrome had significantly larger plaque area and CSA at minimum lumen area (MLA) of LMCA than patients without metabolic syndrome (10.8 ± 3.7mm2 vs 8.2 ± 4.4 mm2, p = 0.01, 25.8 ± 5.0mm2 vs 23.1 ± 5.4 mm2, p = 0.04, respectively). About total plaque volume at LMCA, patients with metabolic syndrome had also significantly larger volume than patients without metabolic syndrome (53.8 ± 24.7mm3 vs 39.8 ± 21.2 mm3, p = 0.021, respectively). Furthermore, the lipid component of plaque volume at LMCA using IB-IVUS was significantly larger in patients with metabolic syndrome than without metabolic syndrome (25.7 ± 12.1mm3 vs 19.3 ± 11.6 mm3, p = 0.038, respectively). Conclusion: These findings suggest that patients with metabolic syndrome have not only larger plaque but also lipid-rich plaque at LMCA than without metabolic syndrome. IVUS and IB-IVUS Parameter at LMCA