PMID: 18180518Jan 9, 2008Paper

Impact of remodeling on cardiac events in patients with angiographically mild left main coronary artery disease

The Journal of Invasive Cardiology
Young Joon HongNeil J Weissman

Abstract

The clinical significance of intravascular ultrasound (IVUS) assessed remodeling in left main coronary artery (LMCA) lesions has not been studied. Thus, we evaluated the impact of coronary arterial remodeling on cardiac events in patients with angiographically mild LMCA disease. Two hundred thirty-six patients who underwent IVUS evaluation to determine the severity of angiographically mild LMCA lesions (diameter stenosis < 50%) were included. Negative remodeling (NR) was defined as a remodeling index (lesion/reference external elastic membrane crosssectional area [CSA]) < 0.95, intermediate remodeling (IR) as between 0.95-1.05, and positive remodeling (PR) as > 1.05. NR was observed in two-thirds of patients (156/236). NR lesions were more proximal in location (45.6% vs. 25.0%; p = 0.003), less frequently associated with soft plaque morphology (23.1% vs. 43.8%; p = 0.001), and had smaller plaque burdens (34.0 +/- 12.0 vs. 40.3 +/- 10.7%; p < 0.001) than IR/PR lesions. At 1-year follow up, LMCA-related cardiac events occurred in 15 patients (6.3%). NR was less frequently associated with LMCA-related cardiac events than IR/PR [6/156 (3.8%) vs. 9/80 (11.3%); p = 0.027]. In lesions associated with LMCA-related events, lumen CSA was...Continue Reading

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