TY - JOUR
T1 - Non-culprit MACE-rate in LRP: The influence of optimal medical therapy using DAPT and statins
AU - Renkens, Mick P. L.
AU - Mintz, Gary S.
AU - Torguson, Rebecca
AU - di Mario, Carlo
AU - ten Cate, Tim
AU - Ali, Ziad A.
AU - Singh, Varinder
AU - Skinner, William
AU - Artis, Andre
AU - Garcia-Garcia, Hector M.
AU - de Winter, Robbert J.
AU - Wykrzykowska, Joanna J.
AU - Waksman, Ron
N1 - Funding Information: Ron Waksman reports serving on the advisory boards of Abbott Vascular, Amgen, Boston Scientific, Cardioset, Cardiovascular Systems Inc., Medtronic, Philips, and Pi-Cardia Ltd.; being a consultant for Abbott Vascular, Amgen, Biotronik, Boston Scientific, Cardioset, Cardiovascular Systems Inc., Medtronic, Philips, Pi-Cardia Ltd., and Transmural Systems; receiving grant support from AstraZeneca, Biotronik, Boston Scientific, and Chiesi; serving on the speakers bureaus of AstraZeneca and Chiesi, and being an investor in MedAlliance and Transmural Systems. Funding Information: Carlo Di Mario is the recipient of research grants (through the Department of Clinical & Experimental Medicine of the University of Florence) from AMGEN, Behring, Chiesi, Daiichi-Sanyo, Edwards, Medtronic, and Shockwave. Funding Information: Hector Garcia-Garcia reports the following institutional grant support: Biotronik, Boston Scientific, Medtronic, Abbott, Neovasc, Shockwave, Phillips, and CorFlow. Funding Information: Ziad Ali reports grants from NIH/NHLBI, Abbott Vascular, and Cardiovascular Systems Inc.; personal fees from Amgen, Astra Zeneca, and Boston Scientific; and equity from Shockwave Medical. Publisher Copyright: © 2021
PY - 2022/4
Y1 - 2022/4
N2 - Background/Purpose: The Lipid Rich Plaque (LRP) study demonstrated the association between coronary plaque lipid content and outcomes. In this LRP substudy, we assessed the impact of optimal medical therapy (OMT) on the occurrence of non-culprit major adverse cardiac events (NC-MACE). Advanced intracoronary imaging modalities are able to identify patients with vulnerable coronary lesion morphology associated with future events. Methods/Materials: A total of 1270 patients who underwent cardiac catheterization for suspected coronary artery disease (CAD) with evaluable maxLCBI4mm in non-culprit vessels and known medical therapy after discharge were followed for 2 years. OMT was defined as the use of a statin and dual antiplatelet therapy (DAPT). Results: Among the 1270 patients included in this substudy, 1110 (87.7%) had PCI for an index event, and 1014 (80%) patients received OMT. Estimated cumulative incidence functions of NC-MACE did not differ significantly between patients treated with or without OMT (log-rank p-value = 0.876). In patients labeled high risk (maxLCBI4mm > 400), cumulative incidence function also did not differ between patients treated with vs without OMT (log-rank p-value = 0.19). Conclusions: In the current LRP analysis, we could not identify a beneficial effect of OMT in the reduction of NC-MACE rate, even in patients with high-risk plaques during 24-month follow-up.
AB - Background/Purpose: The Lipid Rich Plaque (LRP) study demonstrated the association between coronary plaque lipid content and outcomes. In this LRP substudy, we assessed the impact of optimal medical therapy (OMT) on the occurrence of non-culprit major adverse cardiac events (NC-MACE). Advanced intracoronary imaging modalities are able to identify patients with vulnerable coronary lesion morphology associated with future events. Methods/Materials: A total of 1270 patients who underwent cardiac catheterization for suspected coronary artery disease (CAD) with evaluable maxLCBI4mm in non-culprit vessels and known medical therapy after discharge were followed for 2 years. OMT was defined as the use of a statin and dual antiplatelet therapy (DAPT). Results: Among the 1270 patients included in this substudy, 1110 (87.7%) had PCI for an index event, and 1014 (80%) patients received OMT. Estimated cumulative incidence functions of NC-MACE did not differ significantly between patients treated with or without OMT (log-rank p-value = 0.876). In patients labeled high risk (maxLCBI4mm > 400), cumulative incidence function also did not differ between patients treated with vs without OMT (log-rank p-value = 0.19). Conclusions: In the current LRP analysis, we could not identify a beneficial effect of OMT in the reduction of NC-MACE rate, even in patients with high-risk plaques during 24-month follow-up.
KW - Dual antiplatelet therapy
KW - Lipid-rich plaque
KW - Non-culprit major adverse cardiac events
KW - Optimal medical therapy
UR - http://www.scopus.com/inward/record.url?scp=85111141404&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.carrev.2021.07.015
DO - https://doi.org/10.1016/j.carrev.2021.07.015
M3 - Article
C2 - 34303625
SN - 1553-8389
VL - 37
SP - 92
EP - 96
JO - Cardiovascular Revascularization Medicine
JF - Cardiovascular Revascularization Medicine
ER -