Negative remodeling and calcified plaque in octogenarians with acute myocardial infarction : An intravascular ultrasound analysis
The goal of this study was to use intravascular ultrasound (IVUS) to compare octogenarians versus patients
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| Veröffentlicht in: | Journal of the American College of Cardiology 2006-06, Vol.47 (12), p.2413-2419 |
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| container_title | Journal of the American College of Cardiology |
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| creator | HASSANI, Salah-Eddine MINTZ, Gary S WEISSMAN, Neil J FONG, Helen S KIM, Sang-Wook ZHENYI XUE PICHARD, Augusto D SATLER, Lowell F KENT, Kenneth M SUDDATH, William O WAKSMAN, Ron |
| description | The goal of this study was to use intravascular ultrasound (IVUS) to compare octogenarians versus patients |
| doi_str_mv | 10.1016/j.jacc.2005.11.091 |
| format | Article |
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Although octogenarians represent the fastest-growing segment of our population and have a higher risk profile, they are underrepresented in therapeutic trials.
Between 2002 and 2005, 42 octogenarians and 52 patients <65 years of age underwent pre-intervention IVUS within 2 days from onset of an MI. Qualitative and quantitative measurements were performed at the lesion site and at the proximal and distal references. Positive remodeling was defined as a remodeling index (lesion/mean reference arterial area) > or =1.
Elderly patients mostly (71%) presented with non-ST-segment elevation myocardial infarction (NSTEMI), whereas patients <65 years of age presented almost equally with ST-segment elevation myocardial infarction (STEMI) and NSTEMI (56% vs. 44%). The frequency of rupture/dissection was greater in the <65-year-old group (32% vs. 9%, p = 0.009), and culprit lesions contained more thrombus in this group (14% vs. 2%, p = 0.04). Conversely, in octogenarians, lesions were predominantly calcified (57% vs. 10%, p < 0.001) and longer (20.9 +/- 7.8 mm vs. 16.6 +/- 6.1 mm, p = 0.004) with less positive remodeling (19% vs. 56%, p < 0.001). On multivariant logistic regression analysis, age was the only independent predictor of calcified plaque (p = 0.02) and remodeling (p = 0.005).
Negative remodeling and calcified plaque with rare plaque ruptured were common in elderly people with acute MI. These findings may contribute to the difference in clinical presentation and may suggest a different pathophysiologic mechanism of MI in octogenarians.]]></description><identifier>ISSN: 0735-1097</identifier><identifier>EISSN: 1558-3597</identifier><identifier>DOI: 10.1016/j.jacc.2005.11.091</identifier><identifier>PMID: 16781368</identifier><identifier>CODEN: JACCDI</identifier><language>eng</language><publisher>New York, NY: Elsevier Science</publisher><subject>Age ; Age Factors ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Blood clots ; Calcinosis - complications ; Calcinosis - diagnostic imaging ; Calcinosis - pathology ; Cardiology ; Cardiology. Vascular system ; Cardiovascular disease ; Clinical medicine ; Coronary Artery Disease - complications ; Coronary Artery Disease - diagnostic imaging ; Coronary Artery Disease - pathology ; Coronary Disease - complications ; Coronary Disease - diagnostic imaging ; Coronary Disease - pathology ; Coronary heart disease ; Coronary vessels ; Female ; Heart ; Heart attacks ; Humans ; Male ; Medical imaging ; Medical sciences ; Middle Aged ; Myocardial Infarction - complications ; Myocardial Infarction - diagnostic imaging ; Myocardial Infarction - pathology ; Myocarditis. Cardiomyopathies ; Statistical analysis ; Ultrasonography, Interventional</subject><ispartof>Journal of the American College of Cardiology, 2006-06, Vol.47 (12), p.2413-2419</ispartof><rights>2006 INIST-CNRS</rights><rights>Copyright Elsevier Limited Jun 20, 2006</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27922,27923</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17883881$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16781368$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>HASSANI, Salah-Eddine</creatorcontrib><creatorcontrib>MINTZ, Gary S</creatorcontrib><creatorcontrib>WEISSMAN, Neil J</creatorcontrib><creatorcontrib>FONG, Helen S</creatorcontrib><creatorcontrib>KIM, Sang-Wook</creatorcontrib><creatorcontrib>ZHENYI XUE</creatorcontrib><creatorcontrib>PICHARD, Augusto D</creatorcontrib><creatorcontrib>SATLER, Lowell F</creatorcontrib><creatorcontrib>KENT, Kenneth M</creatorcontrib><creatorcontrib>SUDDATH, William O</creatorcontrib><creatorcontrib>WAKSMAN, Ron</creatorcontrib><title>Negative remodeling and calcified plaque in octogenarians with acute myocardial infarction : An intravascular ultrasound analysis</title><title>Journal of the American College of Cardiology</title><addtitle>J Am Coll Cardiol</addtitle><description><![CDATA[The goal of this study was to use intravascular ultrasound (IVUS) to compare octogenarians versus patients <65 years of age with regard to culprit lesion morphology in acute myocardial infarction (MI).
Although octogenarians represent the fastest-growing segment of our population and have a higher risk profile, they are underrepresented in therapeutic trials.
Between 2002 and 2005, 42 octogenarians and 52 patients <65 years of age underwent pre-intervention IVUS within 2 days from onset of an MI. Qualitative and quantitative measurements were performed at the lesion site and at the proximal and distal references. Positive remodeling was defined as a remodeling index (lesion/mean reference arterial area) > or =1.
Elderly patients mostly (71%) presented with non-ST-segment elevation myocardial infarction (NSTEMI), whereas patients <65 years of age presented almost equally with ST-segment elevation myocardial infarction (STEMI) and NSTEMI (56% vs. 44%). The frequency of rupture/dissection was greater in the <65-year-old group (32% vs. 9%, p = 0.009), and culprit lesions contained more thrombus in this group (14% vs. 2%, p = 0.04). Conversely, in octogenarians, lesions were predominantly calcified (57% vs. 10%, p < 0.001) and longer (20.9 +/- 7.8 mm vs. 16.6 +/- 6.1 mm, p = 0.004) with less positive remodeling (19% vs. 56%, p < 0.001). On multivariant logistic regression analysis, age was the only independent predictor of calcified plaque (p = 0.02) and remodeling (p = 0.005).
Negative remodeling and calcified plaque with rare plaque ruptured were common in elderly people with acute MI. These findings may contribute to the difference in clinical presentation and may suggest a different pathophysiologic mechanism of MI in octogenarians.]]></description><subject>Age</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Blood clots</subject><subject>Calcinosis - complications</subject><subject>Calcinosis - diagnostic imaging</subject><subject>Calcinosis - pathology</subject><subject>Cardiology</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular disease</subject><subject>Clinical medicine</subject><subject>Coronary Artery Disease - complications</subject><subject>Coronary Artery Disease - diagnostic imaging</subject><subject>Coronary Artery Disease - pathology</subject><subject>Coronary Disease - complications</subject><subject>Coronary Disease - diagnostic imaging</subject><subject>Coronary Disease - pathology</subject><subject>Coronary heart disease</subject><subject>Coronary vessels</subject><subject>Female</subject><subject>Heart</subject><subject>Heart attacks</subject><subject>Humans</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Myocardial Infarction - complications</subject><subject>Myocardial Infarction - diagnostic imaging</subject><subject>Myocardial Infarction - pathology</subject><subject>Myocarditis. Cardiomyopathies</subject><subject>Statistical analysis</subject><subject>Ultrasonography, Interventional</subject><issn>0735-1097</issn><issn>1558-3597</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpd0Mtq3DAUBmARWppJ2hfIIghKs7N7ZI8u7i6EJimEdtOuzRldJhpkaSrZCbPsm1eQKYWsDj98nBshFwxaBkx83rU71LrtAHjLWAsDOyErxrlqej7IN2QFsucNg0GekrNSdgAgFBvekVMmpGK9UCvy57vd4uyfLM12SsYGH7cUo6Eag_bOW0P3AX8vlvpIk57T1kbMHmOhz35-pKiX2dLpkDRm4zFU5jDr2adIv9DrWPOc8QmLXgJmuoSaSlrqAIwYDsWX9-Stw1Dsh2M9J79uv_68uW8eftx9u7l-aB576OemcxaskR0H5MYgG0y_dk71asON69addBsmYW3QCkCJHQq54cpaDjUMKPpzcvXSd59TvafM4-SLtiFgtGkpo1AwCCGgwo-v4C4tuW5bRsZBMNkx4FVdHtWymawZ99lPmA_jv9dW8OkI6vEYXMaoffnvpKrLV_oX2_SLtg</recordid><startdate>20060620</startdate><enddate>20060620</enddate><creator>HASSANI, Salah-Eddine</creator><creator>MINTZ, Gary S</creator><creator>WEISSMAN, Neil J</creator><creator>FONG, Helen S</creator><creator>KIM, Sang-Wook</creator><creator>ZHENYI XUE</creator><creator>PICHARD, Augusto D</creator><creator>SATLER, Lowell F</creator><creator>KENT, Kenneth M</creator><creator>SUDDATH, William O</creator><creator>WAKSMAN, Ron</creator><general>Elsevier Science</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7T5</scope><scope>7TK</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20060620</creationdate><title>Negative remodeling and calcified plaque in octogenarians with acute myocardial infarction : An intravascular ultrasound analysis</title><author>HASSANI, Salah-Eddine ; MINTZ, Gary S ; WEISSMAN, Neil J ; FONG, Helen S ; KIM, Sang-Wook ; ZHENYI XUE ; PICHARD, Augusto D ; SATLER, Lowell F ; KENT, Kenneth M ; SUDDATH, William O ; WAKSMAN, Ron</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-h303t-2fe0ed7250a5dda19d34ff838b5df2427fb1704dae60a7a2a67b58ee507a29a63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Age</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Blood clots</topic><topic>Calcinosis - complications</topic><topic>Calcinosis - diagnostic imaging</topic><topic>Calcinosis - pathology</topic><topic>Cardiology</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular disease</topic><topic>Clinical medicine</topic><topic>Coronary Artery Disease - complications</topic><topic>Coronary Artery Disease - diagnostic imaging</topic><topic>Coronary Artery Disease - pathology</topic><topic>Coronary Disease - complications</topic><topic>Coronary Disease - diagnostic imaging</topic><topic>Coronary Disease - pathology</topic><topic>Coronary heart disease</topic><topic>Coronary vessels</topic><topic>Female</topic><topic>Heart</topic><topic>Heart attacks</topic><topic>Humans</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Myocardial Infarction - complications</topic><topic>Myocardial Infarction - diagnostic imaging</topic><topic>Myocardial Infarction - pathology</topic><topic>Myocarditis. Cardiomyopathies</topic><topic>Statistical analysis</topic><topic>Ultrasonography, Interventional</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>HASSANI, Salah-Eddine</creatorcontrib><creatorcontrib>MINTZ, Gary S</creatorcontrib><creatorcontrib>WEISSMAN, Neil J</creatorcontrib><creatorcontrib>FONG, Helen S</creatorcontrib><creatorcontrib>KIM, Sang-Wook</creatorcontrib><creatorcontrib>ZHENYI XUE</creatorcontrib><creatorcontrib>PICHARD, Augusto D</creatorcontrib><creatorcontrib>SATLER, Lowell F</creatorcontrib><creatorcontrib>KENT, Kenneth M</creatorcontrib><creatorcontrib>SUDDATH, William O</creatorcontrib><creatorcontrib>WAKSMAN, Ron</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American College of Cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>HASSANI, Salah-Eddine</au><au>MINTZ, Gary S</au><au>WEISSMAN, Neil J</au><au>FONG, Helen S</au><au>KIM, Sang-Wook</au><au>ZHENYI XUE</au><au>PICHARD, Augusto D</au><au>SATLER, Lowell F</au><au>KENT, Kenneth M</au><au>SUDDATH, William O</au><au>WAKSMAN, Ron</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Negative remodeling and calcified plaque in octogenarians with acute myocardial infarction : An intravascular ultrasound analysis</atitle><jtitle>Journal of the American College of Cardiology</jtitle><addtitle>J Am Coll Cardiol</addtitle><date>2006-06-20</date><risdate>2006</risdate><volume>47</volume><issue>12</issue><spage>2413</spage><epage>2419</epage><pages>2413-2419</pages><issn>0735-1097</issn><eissn>1558-3597</eissn><coden>JACCDI</coden><abstract><![CDATA[The goal of this study was to use intravascular ultrasound (IVUS) to compare octogenarians versus patients <65 years of age with regard to culprit lesion morphology in acute myocardial infarction (MI).
Although octogenarians represent the fastest-growing segment of our population and have a higher risk profile, they are underrepresented in therapeutic trials.
Between 2002 and 2005, 42 octogenarians and 52 patients <65 years of age underwent pre-intervention IVUS within 2 days from onset of an MI. Qualitative and quantitative measurements were performed at the lesion site and at the proximal and distal references. Positive remodeling was defined as a remodeling index (lesion/mean reference arterial area) > or =1.
Elderly patients mostly (71%) presented with non-ST-segment elevation myocardial infarction (NSTEMI), whereas patients <65 years of age presented almost equally with ST-segment elevation myocardial infarction (STEMI) and NSTEMI (56% vs. 44%). The frequency of rupture/dissection was greater in the <65-year-old group (32% vs. 9%, p = 0.009), and culprit lesions contained more thrombus in this group (14% vs. 2%, p = 0.04). Conversely, in octogenarians, lesions were predominantly calcified (57% vs. 10%, p < 0.001) and longer (20.9 +/- 7.8 mm vs. 16.6 +/- 6.1 mm, p = 0.004) with less positive remodeling (19% vs. 56%, p < 0.001). On multivariant logistic regression analysis, age was the only independent predictor of calcified plaque (p = 0.02) and remodeling (p = 0.005).
Negative remodeling and calcified plaque with rare plaque ruptured were common in elderly people with acute MI. These findings may contribute to the difference in clinical presentation and may suggest a different pathophysiologic mechanism of MI in octogenarians.]]></abstract><cop>New York, NY</cop><pub>Elsevier Science</pub><pmid>16781368</pmid><doi>10.1016/j.jacc.2005.11.091</doi><tpages>7</tpages></addata></record> |
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| subjects | Age Age Factors Aged Aged, 80 and over Biological and medical sciences Blood clots Calcinosis - complications Calcinosis - diagnostic imaging Calcinosis - pathology Cardiology Cardiology. Vascular system Cardiovascular disease Clinical medicine Coronary Artery Disease - complications Coronary Artery Disease - diagnostic imaging Coronary Artery Disease - pathology Coronary Disease - complications Coronary Disease - diagnostic imaging Coronary Disease - pathology Coronary heart disease Coronary vessels Female Heart Heart attacks Humans Male Medical imaging Medical sciences Middle Aged Myocardial Infarction - complications Myocardial Infarction - diagnostic imaging Myocardial Infarction - pathology Myocarditis. Cardiomyopathies Statistical analysis Ultrasonography, Interventional |
| title | Negative remodeling and calcified plaque in octogenarians with acute myocardial infarction : An intravascular ultrasound analysis |
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