Culprit lesion morphology in young patients with ST-segment elevated myocardial infarction: A clinical, angiographic and optical coherence tomography study
Culprit lesion morphology in young patients with ST-segment elevated myocardial infarction: A clinical, angiographic and optical coherence tomography study
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ST 段抬高型心肌梗死年轻患者的罪魁祸首病变形态：临床、血管造影和光学相干断层扫描研究
DOI：
10.1016/j.atherosclerosis.2019.08.011
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发表时间：
2019-10-01
期刊：
影响因子：
5.3
通讯作者：
Yu, Bo
中科院分区：
文献类型：
--
作者：
Fang, Chao;Dai, Jiannan;Yu, Bo
背景和目的：大约20%的ST段抬高型心肌梗死（STEMI）患者是年轻人。年轻STEMI患者罪犯病变的形态学特征尚未在体内进行系统评价。方法：1442例STEMI患者行OCT检查，年龄50岁（青年组）400例，年龄> 50岁（老年组）1042例。比较两组患者的临床特征、血管造影和OCT表现。与老年患者相比，（80.5% vs. 87.2%，p= 0.001），薄帽纤维粥样硬化（TCFA，59.5% vs. 69.5%，p < 0.001），钙化（31.3% vs. 48.7%，p < 0.001）、点状钙化（25.3% vs. 36.1%，p < 0.001）和胆固醇结晶（26.3% vs. 38.4%，p < 0.001）在年轻患者中较少见。从70岁开始观察到典型斑块易损性的梯度增加。在多因素回归分析中，年龄=50岁与斑块破裂、TCFA、斑点状钙化、胆固醇结晶和管腔面积狭窄的频率较低独立相关。结论：年轻STEMI患者罪犯病变的形态学特征不同于老年患者。岁的患者
Background and aims: About 20% of patients with ST-segment elevated myocardial infarction (STEMI) are young adults. Morphological characteristics of culprit lesion in young STEMI patients have not been systematically evaluated in vivo. The present study aimed to investigate culprit lesion characteristics in young patients versus older patients using optical coherence tomography (OCT).Methods: 1442 STEMI patients who underwent OCT examination of culprit lesion were included and divided into young group (age =50 years, n= 400) and older group (age> 50 years, n= 1042). Clinical characteristics, angiography and OCT findings were compared between the two groups.Results: Culprit lesions in STEMI patients aged 50 years. As compared with older patients, lipid rich plaque (80.5% vs. 87.2%, p= 0.001), thin cap fibroatheroma (TCFA, 59.5% vs. 69.5%, p < 0.001), calcification (31.3% vs. 48.7%, p < 0.001), spotty calcification (25.3% vs. 36.1%, p < 0.001) and cholesterol crystals (26.3% vs. 38.4%, p < 0.001) were less frequently observed in young patients. A gradient increase in typical plaque vulnerability was observed from age 70 years. In multivariate regression analysis, age =50 years was independently associated with less frequency of plaque rupture, TCFA, spotty calcification, cholesterol crystals and smaller lumen area stenosis.Conclusions: Morphological characteristics of culprit lesion in young STEMI patients were different from those in older patients. Patients aged