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Association of the age shock index with coronary plaque characteristics in ST-segment elevation myocardial
Linlin Zhao1,2, Zhuo Du1,2, Tianyu Wu1,2
1Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
Insights
A high age shock index (SI) in ST-segment elevation myocardial infarction (STEMI) patients is linked to more ruptured plaques and vulnerable features. This suggests increased pancoronary vulnerability in these patients.
Area of Science:
- Cardiology
- Interventional Cardiology
- Biomarkers
Background:
- The age shock index (SI) is a clinical parameter that predicts poor outcomes in ST-segment elevation myocardial infarction (STEMI) patients.
- Understanding the relationship between age SI and coronary plaque characteristics is crucial for risk stratification.
Purpose of the Study:
- To investigate the association between the age shock index (SI) and coronary plaque characteristics in patients with STEMI.
- To determine if age SI correlates with plaque vulnerability using optical coherence tomography (OCT).
Main Methods:
- Retrospective study of 408 STEMI patients undergoing 3-vessel OCT during percutaneous coronary interventions.
- Patients were categorized into low (<41) and high (≥41) age SI groups.
- Plaque characteristics were compared between groups for culprit and non-culprit lesions.
Main Results:
- High age SI (≥41) was associated with increased plaque rupture and thinner fibrous caps in culprit lesions.
- In non-culprit lesions, high age SI correlated with a higher prevalence of high-risk plaques, including larger lipid cores and thinner fibrous caps.
- Plaque analysis revealed larger lipid cores and thinner fibrous caps in patients with high age SI.
Conclusions:
- Patients with STEMI and a high age SI exhibit a greater risk of culprit plaque rupture and high-risk non-culprit plaques.
- A high age SI may indicate increased pancoronary vulnerability, characterized by vulnerable plaque features in both culprit and non-culprit lesions.
- Age SI serves as a valuable indicator of plaque vulnerability in STEMI patients.
Objectives:
We investigated whether the age shock index (SI) was associated with coronary plaque characteristics in patients with ST-segment elevation myocardial infarction (STEMI) using optical coherence tomography (OCT).
Background:
The age SI is a simple clinical parameter that effectively predicts poor clinical outcomes among patients with STEMI.
Methods:
This retrospective study evaluated 408 STEMI patients who underwent 3-vessel OCT during emergency percutaneous coronary interventions at a single center between January 2017 and October 2018. Patients were divided into groups with low or high age SI values (<41 vs. ≥41). Plaque characteristics were compared between the two groups for both culprit lesions (n = 408) and non-culprit lesions (n = 1,077).
Results:
In culprit lesions, patients with a high age SI (≥41) were more likely to have plaque rupture (61.0% vs. 56.8%, p = .002) and thinner fibrous caps (fibrous cap thickness [FCT]: 40.0 [33.0-53.0] μm vs. 46.0 [36.0-63.8] μm, p = .021). In non-culprit lesions, patients with a high age SI were more likely to have high-risk plaques (29.9% vs. 17.8%, p = .018; simultaneous presence of a minimal lumen area of <3.5 mm2 , maximum lipid arc of >180°, FCT of <75 μm, and macrophage accumulation). Plaque-based analyses revealed that patients with a high age SI had larger lipid cores and lesser FCT.
Conclusions:
Patients with STEMI and a high age SI had increased risks of culprit plaque rupture and high-risk non-culprit plaques, and vulnerable plaque features at the culprit and non-culprit lesions. Therefore, a high age SI in patients with STEMI may indicate greater pancoronary vulnerability.
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