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Long-term MACEs more likely associated with nonculprit coronary lesions

23 Dec 2019

Nonculprit coronary lesions (NCLs) come with higher long-term risks of major adverse cardiovascular events (MACEs) than culprit lesions (CLs), a recent study has found.

Eighty-two patients (mean age, 60.2±11.6 years; 72 percent male) with NCL, corresponding to 86 lesions, were followed for 10 years for the development of MACEs. Lesions were evaluated using virtual histology-intravascular ultrasound. MACEs were defined as all-cause mortality, myocardial infarction, stroke and revascularization. Outcomes were stratified according to lesion status.

Twenty patients developed MACEs over the study period, yielding an incidence rate of 24.4 percent. The median time to the occurrence of an event was 101.0±46.9 months. Twelve deaths were reported overall, five of which were related to CL or NCL, while the remaining seven were of unknown causes.

The incidence of MACEs related to NCLs was 25.6 percent, developing in 20 patients with 22 lesions. The corresponding rate associated with CLs was 12.8 percent, occurring in 10 patients with 11 lesions. MACEs associated with CLs or NCLs of unknown causes occurred in six participants, resulting in an incidence rate of 7.0 percent.

Ten-year cumulative revascularization was comparable between the intermediate NCLs and CLs (17.4 percent vs 15.1 percent). However, rates were more than doubled when intermediate was compared against minimal NCL (17.4 percent vs 8.1 percent).

“Intermediate NCL can be safely followed up with optimal medical treatment in terms of revascularization risk because this very long-term follow-up study revealed that the chance of revascularization rate was similar between treated CL and untreated intermediate NCL,” said researchers.

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Most Read Articles
01 Nov 2019
Women with hypertensive disorders of pregnancy, especially pre-eclampsia, are at heightened risk of developing cardiovascular disorder and chronic hypertension, with the risk becoming apparent soon after pregnancy, a study has found.
Roshini Claire Anthony, 29 May 2019

Gestational diabetes and abnormal glucose levels in pregnancy, as determined with an oral glucose challenge test (OGCT) at 24–28 weeks gestation, could signal a future risk of cardiovascular disease (CVD)*, according to a recent study.

07 Jul 2019
Plasma creatinine kinase activity, measure during early pregnancy, influences blood pressure during pregnancy and contributes to severe gestational hypertension diagnosed before 34 weeks of gestation, according to a recent study. There is no association between creatinine kinase and other hypertensive disorders during pregnancy.
Pank Jit Sin, 16 Oct 2019
While a diagnosis of cancer is often met with concern and devastation, the same is barely true for heart failure. However, the mortality rate for those suffering from heart failure is worse than some common cancers, such as prostate and breast cancers.