Related Experiment Video
Updated: Aug 16, 2025
Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
Predictors of Adverse Prognosis in Patients With Acute Coronary Syndrome Caused by Plaque Erosion With a Nonstent
Yanwei Yin1, Fangmeng Lei1, Chao Fang1
1Department of Cardiology Second Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education Harbin China.
Insights
A non-stent strategy for acute coronary syndrome from plaque erosion is viable. Older age, greater stenosis, and higher thrombus burden predict worse outcomes in these patients.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Biology
Background:
- The EROSION study established the safety of antithrombotic therapy without stenting for acute coronary syndrome (ACS) due to plaque erosion.
- Predictors of long-term prognosis in this patient group remain unclear, necessitating further investigation.
Purpose of the Study:
- To identify predictors of adverse prognosis in patients treated with a non-stent strategy for ACS caused by plaque erosion.
- To validate these predictors in a larger patient cohort.
Main Methods:
- A cohort of 252 patients with ACS and plaque erosion, including 55 from the EROSION study, were analyzed.
- Major adverse cardiovascular events (MACE) were defined as cardiac death, recurrent MI, revascularization, angina rehospitalization, bleeding, or stroke.
- Multivariate Cox regression identified predictors of MACE at a median follow-up of 2.9 years.
Main Results:
- Among 232 patients, 21.6% experienced MACE.
- Patients with MACE were older, with higher baseline percentage area stenosis (72.2% vs. 64.2%) and thrombus burden (24.4% vs. 20.4%).
- Age (≥60 years), area stenosis (≥63.5%), and thrombus burden (≥18.5%) were independent predictors of MACE.
Conclusions:
- The non-stent strategy for ACS from plaque erosion shows heterogeneous outcomes.
- Specific patient characteristics—age ≥60 years, area stenosis ≥63.5%, and thrombus burden ≥18.5%—are associated with a higher risk of MACE.
Abstract:
Background The EROSION (Effective Anti-Thrombotic Therapy Without Stenting: Intravascular Optical Coherence Tomography-Based Management in Plaque Erosion) study demonstrated that antithrombotic therapy without stenting was safe and feasible in selected patients with acute coronary syndrome caused by plaque erosion. However, the factors related to the prognosis of these patients are not clear. This study aimed to explore the predictors of an adverse prognosis of a nonstent strategy in a larger sample size. Methods and Results A total of 252 (55 patients were from the EROSION study) patients with acute coronary syndrome with plaque erosion who met the inclusion criteria of the EROSION study and completed clinical follow-up were enrolled. Patients were divided into 2 groups according to the occurrence of major adverse cardiovascular events (MACE), which were defined as the composite of cardiac death, recurrent myocardial infarction, ischemia-driven target lesion revascularization, rehospitalization because of unstable or progressive angina, major bleeding, and stroke. Among 232 patients with acute coronary syndrome included in the final analysis, 50 patients (21.6%) developed MACE at a median follow-up of 2.9 years. Compared with patients without MACE, patients with MACE were older and had a higher degree of percentage of area stenosis (72.2%±9.4% versus 64.2%±15.7%, P<0.001) and thrombus burden (24.4%±10.4% versus 20.4%±10.9%, P=0.010) at baseline. Multivariate Cox regression analysis confirmed that age, percentage of area stenosis, and thrombus burden were predictors of MACE. The best cutoff values of predictors were age ≥60 years, percentage of area stenosis ≥63.5%, and thrombus burden ≥18.5%, respectively, and when they were all present, the rate of MACE rose to 57.7%. Conclusions The nonstent treatment strategy of patients with acute coronary syndrome caused by plaque erosion was heterogeneous, and patients aged ≥60 years, percentage of area stenosis ≥63.5%, and thrombus burden ≥18.5% may predict a worse clinical outcome.
More Related Videos
13:07Optical Coherence Tomography Based Biomechanical Fluid-Structure Interaction Analysis of Coronary Atherosclerosis Progression
Published on: January 15, 2022
07:25Predicting Amputation using Local Circulating Mononuclear Progenitor Cells in Angioplasty-treated Patients with Critical Limb Ischemia
Published on: September 22, 2020
Related Concept Videos
01:26Coronary Artery Disease II: Pathophysiology
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:30Atherosclerosis I: Introduction
01:30Acute Coronary Syndrome I: Introduction
01:30Coronary Artery Disease I: Introduction
01:30Acute Coronary Syndrome III: Diagnostic Studies