Abstract

Background: In many countries, coronary artery disease (CAD) is one of the most common causes of death, and stable angina pectoris (SAP) is the most common initial symptomatic presentation. Despite the contemporary evolution of percutaneous coronary intervention (PCI) using drug-eluting stenting and a drug-coated balloon, restenosis and repeat revascularization still remain major concerns and are limiting the efficacy of PCI in patients with SAP . The characteristics of high-risk coronary atherosclerosis evaluated by optical coherence tomography (OCT) were suggested to have a prognostic role. Inflammatory biomarkers may be related to coronary artery disease severity. Accordingly, this study aimed to investigate the association of high-risk coronary plaque morphologies detected by OCT with circulating inflammatory biomarkers and adverse cardiovascular events. Methods: We prospectively analyzed the data of 30 consecutive patients with stable angina pectoris (SAP) who underwent percutaneous coronary intervention (PCI) using optical coherence tomography (OCT) between April 2020 and November 2020 in our university hospital. Inflammatory biomarker measurement and an OCT analysis focused on high-risk coronary plaque features were performed. Based on the coronary plaque risk score (CPRS), patients were defined as having a low CPRS (CPRS ≤3) or high CPRS (CPRS ≥4). The primary outcome was target lesion revascularization (TLR). Results: TLR occurred in 6 patients (20%) within 15 months after PCI. A high CPRS assessed by OCT was directly correlated to TLR (P=0.029). In a logistic regression analysis, the CPRS was associated with TLR (odds ratio, 10.0; 95% confidence interval, 1.34-74.5). Among inflammatory biomarkers, MCP-1 was significantly correlated with the CPRS (P=0.020). Conclusions: In patients with SAP, the CPRS may be a potential surrogate index for predicting TLR. MCP-1 might be useful for detecting high-risk coronary atherosclerosis.

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