AI Article Synopsis
- - The study investigates the characteristics of atherosclerotic plaques in young Indian patients (ages 18-50) who experience acute coronary syndrome (ACS) and undergo a procedure called percutaneous coronary intervention (PCI) using advanced imaging known as optical coherence tomography (OCT).
- - A total of 100 patients were analyzed, revealing that the majority (75%) had fibrous plaques, while other types included those with macrophages (27%) and microchannels (20%). Significant occurrences of plaque rupture and erosion were also noted among the patients.
- - Findings indicate that young Indian patients with ACS predominantly present with fibrous plaques, highlighting the need for understanding their plaque profiles for better management and prevention strategies in this demographic.
Article Abstract
Objectives: The prevalence of atherosclerosis and acute coronary syndrome (ACS) is increasing in young Indians (18-50 years of age). However, the characteristics of atherosclerotic plaques in such individuals are poorly understood, presenting distinct challenges for the management of ACS. This study aims to analyze plaque characteristics in young Indian patients with ACS who underwent percutaneous coronary intervention (PCI) using optical coherence tomography (OCT) imaging.
Methods: This was a prospective, multicentric, non-interventional study on patients aged 18-50 years presenting with ST-elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction, or unstable angina, and were scheduled to undergo OCT-guided PCI. Major adverse cardiac events (MACE) were assessed post-procedure and at the 6-month and 12-month follow-ups.
Results: The study included 100 ACS patients (mean age = 43.6 ± 5.2 years), with 51% presenting with STEMI. Pre-PCI OCT assessment showed that fibrous plaques (75%) were most common followed by plaques containing macrophages (27%), microchannels (20%), and calcified nodules (14%). In addition, plaque rupture, plaque erosion, and lipid-rich plaques, along with red, white, and mixed thrombi, were observed in 31%, 25%, 24%, 21%, 14%, and 17% (total thrombus occurrence = 52%) of the patients, respectively. At 12 months, the MACE (coronary artery bypass graft) rate was 1%.
Conclusions: Young Indian patients with ACS displayed a range of plaque morphologies identified through pre-PCI OCT. Among these, fibrous plaques were the most prominent type, followed by plaques containing macrophages. Additionally, plaque rupture, plaque erosion, and lipid-rich plaques were also observed in this population.
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| http://dx.doi.org/10.1016/j.ihj.2024.11.001 | DOI Listing |
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