Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China.
Catheter Cardiovasc Interv. 2021 May 1;97 Suppl 2:1080-1088. doi: 10.1002/ccd.29652. Epub 2021 Mar 29.
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).
The age SI is a simple clinical parameter that effectively predicts poor clinical outcomes among patients with STEMI.
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).
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 mm , 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.
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.
我们使用光学相干断层扫描（OCT）研究了年龄休克指数（SI）与 ST 段抬高型心肌梗死（STEMI）患者冠状动脉斑块特征的关系。
年龄 SI 是一种简单的临床参数，可有效预测 STEMI 患者的不良临床结局。
本回顾性研究评估了 2017 年 1 月至 2018 年 10 月期间在一家中心接受紧急经皮冠状动脉介入治疗的 408 例 STEMI 患者，这些患者接受了 3 支血管 OCT 检查。患者被分为低年龄 SI（<41）和高年龄 SI（≥41）组。比较两组罪犯病变（n=408）和非罪犯病变（n=1077）的斑块特征。
在罪犯病变中，高年龄 SI（≥41）患者更易发生斑块破裂（61.0% vs. 56.8%，p=0.002）和纤维帽更薄（纤维帽厚度[FCT]：40.0[33.0-53.0]μm vs. 46.0[36.0-63.8]μm，p=0.021）。在非罪犯病变中，高年龄 SI 患者更易发生高危斑块（29.9% vs. 17.8%，p=0.018；同时存在管腔面积<3.5mm 、最大脂质弧>180°、FCT<75μm 和巨噬细胞堆积）。斑块分析显示，高年龄 SI 患者的脂质核心更大，FCT 更小。
STEMI 患者年龄 SI 较高，罪犯斑块破裂和高危非罪犯斑块的风险增加，罪犯和非罪犯病变的易损斑块特征增加。因此，STEMI 患者的高年龄 SI 可能表明更广泛的冠状动脉易损性。
