Association of the age shock index with coronary plaque characteristics in ST‐segment elevation myocardial infarction: A 3‐vessel optical coherence tomography study

Abstract

Objectives: We investigated whether the age shock index (SI) was associated with coronary plaque characteristics in patients with ST-segment elevation myocardial infarction (STEMI) using optical coherence tomography (OCT). Background:The age SI is a simple clinical parameter that effectively predicts poor clinical outcomes among patients with STEMI. Methods: This retrospective study evaluated 408 STEMI patients who underwent 3-vessel OCT during emergency percutaneous coronary interventions at a single center between January 2017 and October 2018. Patients were divided into groups with low or high age SI values (<41 vs. ≥41). Plaque characteristics were compared between the two groups for both culprit lesions (n = 408) and non-culprit lesions (n = 1,077).Results: In culprit lesions, patients with a high age SI (≥41) were more likely to have plaque rupture (61.0% vs. 56.8%, p = .002) and thinner fibrous caps (fibrous cap thickness [FCT]: 40.0 [33.0-53.0] μm vs. 46.0 [36.0-63.8] μm, p = .021). In nonculprit lesions, patients with a high age SI were more likely to have high-risk plaques (29.9% vs. 17.8%, p = .018; simultaneous presence of a minimal lumen area of <3.5 mm 2 , maximum lipid arc of >180 , FCT of <75 μm, and macrophage accumulation). Plaque-based analyses revealed that patients with a high age SI had larger lipid cores and lesser FCT.Conclusions: Patients with STEMI and a high age SI had increased risks of culprit plaque rupture and high-risk non-culprit plaques, and vulnerable plaque features at the culprit and non-culprit lesions. Therefore, a high age SI in patients with STEMI may indicate greater pancoronary vulnerability.

Characteristics of calcified nodule attributable to culprit lesion in acute coronary syndrome: A systematic review and meta-analysis

“… 10 USA Cross-sectional – Fair 70.0 ± 12.6 13 524 25 4.8 Histopathology 20 Zhang et al., 2021 Japan Cross-sectional – Fair N/A N/A 704 20 2.8 OCT 21 Zhao et al. 27 China Cohort Retrospective Good N/A N/A 408 12 2.9 OCT 22 Lei et al. 28 China Cohort Retrospective Good 65.9 ± 9.5 37 2593 56 2.2 OCT 23 Li et al.…”

“…This review engaged subjects from a total of 24 observational studies, comprising of 17 cohort, 6 cross-sectional. Four studies were multinational, 13 , 16 , 20 , 30 while three studies were from China, 27 , 28 , 29 two studies were from the United States of America, 10 , 15 one study was from Brazil, 23 one study was from Spain, 6 and the remaining thirteen were originated from Japan 5 , 7 , 8 , 17 , 21 , 14 , 18 , 19 , 22 , 24 , 25 , 26 , 64 ( Table 1 ). All included studies employed consecutive sampling, even though samples from Wang et al.…”