Non-Culprit MACE Rate in LRP: The Influence of Optimal Medical Therapy Using DAPT and Statins. Non-culprit MACE-rate in LRP: The influence of optimal medical therapy using DAPT and statins.

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Citation: Cardiovascular Revascularization Medicine. 37:92-96, 2022 Apr.PMID: 34303625Institution: MedStar Heart & Vascular Institute | MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Coronary Artery Disease | *Hydroxymethylglutaryl-CoA Reductase Inhibitors | *Percutaneous Coronary Intervention | *Plaque, Atherosclerotic | Coronary Artery Disease/co [Complications] | Coronary Artery Disease/dg [Diagnostic Imaging] | Coronary Artery Disease/th [Therapy] | Humans | Hydroxymethylglutaryl-CoA Reductase Inhibitors/ae [Adverse Effects] | Lipids | Percutaneous Coronary Intervention/ae [Adverse Effects] | Percutaneous Coronary Intervention/mt [Methods] | Plaque, Atherosclerotic/pa [Pathology] | Platelet Aggregation Inhibitors/ae [Adverse Effects] | Treatment OutcomeYear: 2022ISSN:
  • 1878-0938
Name of journal: Cardiovascular revascularization medicine : including molecular interventionsAbstract: 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.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. Copyright (c) 2021. Published by Elsevier Inc.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).All authors: Ali ZA, Artis A, de Winter RJ, Di Mario C, Garcia-Garcia HM, Mintz GS, Renkens MPL, Singh V, Skinner W, Ten Cate T, Torguson R, Waksman R, Wykrzykowska JJOriginally published: Cardiovascular Revascularization Medicine. 2021 Jul 17Fiscal year: FY2022Digital Object Identifier: Date added to catalog: 2021-11-01
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Journal Article MedStar Authors Catalog Article 34303625 Available 34303625

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.

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. Copyright (c) 2021. Published by Elsevier Inc.

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).

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