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Optical Coherence Tomography Based Biomechanical Fluid-Structure Interaction Analysis of Coronary Atherosclerosis Progression
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Predictors of Coronary Plaque Erosion in Current and Non-Current Smokers With ST-Segment Elevation Myocardial

Yidan Wang1, Chao Fang1, Shaotao Zhang1

  • 1Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education.

Circulation Journal : Official Journal of the Japanese Circulation Society
|January 28, 2021
PubMed

Insights

Smoking is linked to plaque erosion in ST-segment elevation myocardial infarction (STEMI). Predictors differ between current and non-current smokers, with diabetes influencing rupture risk in current smokers and lesion characteristics in non-current smokers.

Area of Science:

  • Cardiology
  • Vascular Biology
  • Interventional Cardiology

Background:

  • Smoking is a significant risk factor for plaque erosion.
  • ST-segment elevation myocardial infarction (STEMI) can result from plaque rupture or erosion.

Purpose of the Study:

  • To identify predictors of plaque erosion versus plaque rupture in STEMI patients.
  • To compare these predictors between current and non-current smokers.

Main Methods:

  • Retrospective analysis of 1,320 STEMI patients.
  • Culprit lesions assessed by optical coherence tomography.
  • Division into current (n=715) and non-current (n=605) smokers.
  • Multivariable logistic regression analysis.

Main Results:

  • Plaque erosion was more frequent in current smokers (30.8%) than non-current smokers (21.2%).
  • Independent predictors of plaque erosion (vs. rupture) regardless of smoking status included younger age (<50 years), single-vessel disease, and absence of dyslipidemia.
  • In current smokers, diabetes mellitus was negatively associated with plaque erosion (OR=0.29).
  • In non-current smokers, minimal lumen area (MLA) (OR=1.37) and nearby bifurcation (OR=3.20) were associated with plaque erosion.

Conclusions:

  • Diabetes mellitus may increase rupture-based STEMI risk in current smokers.
  • Nearby bifurcation and larger MLA are associated with plaque erosion in non-current smokers.
  • Predictors of plaque erosion in STEMI differ based on smoking status.
Abstract

Keywords:
Optical coherence tomographyPlaque erosionST-segment elevation myocardial infarctionSmoking

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