{"title":"慢性冠状动脉综合征病变不规则突出的序列变化及临床影响。","authors":"Naotaka Okamoto, Isamu Mizote, Takayuki Ishihara, Daisuke Nakamura, Tatsusya Shiraki, Naoki Itaya, Takuya Tsujimura, Mitsuyoshi Takahara, Shungo Hikosou, Toshiaki Mano, Takahumi Ueno, Masami Nishino, Shinsuke Nanto, Yasushi Sakata","doi":"10.1002/ccd.31430","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>The changes over time and effects on long-term clinical outcomes beyond 1 year of irregular protrusion (IP) in chronic coronary syndrome (CCS) remains unclear.</p>\n </section>\n \n <section>\n \n <h3> Aims</h3>\n \n <p>This study aimed to assess the time-dependent change and long-term clinical impact of IP in CCS lesions.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This study was a post hoc analysis of COLLABORATION study, which was a multicenter, prospective, observational study conducted from July 2018 to February 2020, assessing 1- and 12-month serial vessel responses after stent implantation using OCT and coronary angioscopy. Time-dependent change in the presence of IP was evaluated using the serial OCT examinations. The cumulative 3-year incidence of TLR was compared between the lesions with and without IP, as well as between those with and without residual IP at 1 month.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Among 107 lesions, IP was detected in post-OCT pullbacks in 38 (35.5%) lesions. Out of the 38 lesions, IP remained in 9 (23.7%) lesions at 1 month and existed in 2 (5.3%) lesions at 12 months. The cumulative 3-year incidence of TLR was significantly higher in IP group than in non-IP group (13.6% vs. 3.0%, <i>p</i> = 0.04). Similarly, it was significantly higher in lesions with residual IP at 1 month than those without (33.3% vs. 4.3%, <i>p</i> < 0.01). All residual IP at 1 month were composed of angioscopic yellow plaques and red thrombi.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>The presence of IP decreased over time, but approximately one-fourth of IP remained at 1 month. IP and residual IP at 1 month were important post-stent OCT findings leading to long-term TLR in patients with CCS.</p>\n </section>\n </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"105 5","pages":"1149-1160"},"PeriodicalIF":2.1000,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ccd.31430","citationCount":"0","resultStr":"{\"title\":\"Serial Change and Clinical Impact of Irregular Protrusion in Lesions With Chronic Coronary Syndrome\",\"authors\":\"Naotaka Okamoto, Isamu Mizote, Takayuki Ishihara, Daisuke Nakamura, Tatsusya Shiraki, Naoki Itaya, Takuya Tsujimura, Mitsuyoshi Takahara, Shungo Hikosou, Toshiaki Mano, Takahumi Ueno, Masami Nishino, Shinsuke Nanto, Yasushi Sakata\",\"doi\":\"10.1002/ccd.31430\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>The changes over time and effects on long-term clinical outcomes beyond 1 year of irregular protrusion (IP) in chronic coronary syndrome (CCS) remains unclear.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Aims</h3>\\n \\n <p>This study aimed to assess the time-dependent change and long-term clinical impact of IP in CCS lesions.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>This study was a post hoc analysis of COLLABORATION study, which was a multicenter, prospective, observational study conducted from July 2018 to February 2020, assessing 1- and 12-month serial vessel responses after stent implantation using OCT and coronary angioscopy. Time-dependent change in the presence of IP was evaluated using the serial OCT examinations. The cumulative 3-year incidence of TLR was compared between the lesions with and without IP, as well as between those with and without residual IP at 1 month.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Among 107 lesions, IP was detected in post-OCT pullbacks in 38 (35.5%) lesions. Out of the 38 lesions, IP remained in 9 (23.7%) lesions at 1 month and existed in 2 (5.3%) lesions at 12 months. The cumulative 3-year incidence of TLR was significantly higher in IP group than in non-IP group (13.6% vs. 3.0%, <i>p</i> = 0.04). Similarly, it was significantly higher in lesions with residual IP at 1 month than those without (33.3% vs. 4.3%, <i>p</i> < 0.01). All residual IP at 1 month were composed of angioscopic yellow plaques and red thrombi.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>The presence of IP decreased over time, but approximately one-fourth of IP remained at 1 month. IP and residual IP at 1 month were important post-stent OCT findings leading to long-term TLR in patients with CCS.</p>\\n </section>\\n </div>\",\"PeriodicalId\":9650,\"journal\":{\"name\":\"Catheterization and Cardiovascular Interventions\",\"volume\":\"105 5\",\"pages\":\"1149-1160\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2025-02-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ccd.31430\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Catheterization and Cardiovascular Interventions\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/ccd.31430\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Catheterization and Cardiovascular Interventions","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/ccd.31430","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
摘要
背景：慢性冠状动脉综合征（CCS）患者1年以上的不规则突出（IP）随时间的变化及其对长期临床结果的影响尚不清楚。目的：本研究旨在评估IP在CCS病变中的时间依赖性变化和长期临床影响。方法：本研究是协作研究的事后分析，协作研究是一项多中心、前瞻性、观察性研究，于2018年7月至2020年2月进行，使用OCT和冠状动脉血管镜评估支架植入术后1个月和12个月的连续血管反应。使用连续OCT检查评估IP存在时的时间依赖性变化。比较3年TLR的累积发生率，包括有和没有IP的病变，以及在1个月时有和没有IP残留的病变。结果：107例病变中，有38例（35.5%）病变在oct后回缩中检出IP。在38个病变中，9个（23.7%）病变在1个月时仍存在IP， 2个（5.3%）病变在12个月时仍存在IP。IP组3年TLR累计发生率显著高于非IP组（13.6% vs. 3.0%, p = 0.04）。同样，1个月时残留IP的病变明显高于无IP的病变（33.3% vs. 4.3%, p）。结论：IP的存在随着时间的推移而减少，但大约四分之一的IP在1个月时仍然存在。1个月的IP和剩余IP是导致CCS患者长期TLR的重要支架后OCT发现。
Serial Change and Clinical Impact of Irregular Protrusion in Lesions With Chronic Coronary Syndrome
Background
The changes over time and effects on long-term clinical outcomes beyond 1 year of irregular protrusion (IP) in chronic coronary syndrome (CCS) remains unclear.
Aims
This study aimed to assess the time-dependent change and long-term clinical impact of IP in CCS lesions.
Methods
This study was a post hoc analysis of COLLABORATION study, which was a multicenter, prospective, observational study conducted from July 2018 to February 2020, assessing 1- and 12-month serial vessel responses after stent implantation using OCT and coronary angioscopy. Time-dependent change in the presence of IP was evaluated using the serial OCT examinations. The cumulative 3-year incidence of TLR was compared between the lesions with and without IP, as well as between those with and without residual IP at 1 month.
Results
Among 107 lesions, IP was detected in post-OCT pullbacks in 38 (35.5%) lesions. Out of the 38 lesions, IP remained in 9 (23.7%) lesions at 1 month and existed in 2 (5.3%) lesions at 12 months. The cumulative 3-year incidence of TLR was significantly higher in IP group than in non-IP group (13.6% vs. 3.0%, p = 0.04). Similarly, it was significantly higher in lesions with residual IP at 1 month than those without (33.3% vs. 4.3%, p < 0.01). All residual IP at 1 month were composed of angioscopic yellow plaques and red thrombi.
Conclusions
The presence of IP decreased over time, but approximately one-fourth of IP remained at 1 month. IP and residual IP at 1 month were important post-stent OCT findings leading to long-term TLR in patients with CCS.
期刊介绍：
Catheterization and Cardiovascular Interventions is an international journal covering the broad field of cardiovascular diseases. Subject material includes basic and clinical information that is derived from or related to invasive and interventional coronary or peripheral vascular techniques. The journal focuses on material that will be of immediate practical value to physicians providing patient care in the clinical laboratory setting. To accomplish this, the journal publishes Preliminary Reports and Work In Progress articles that complement the traditional Original Studies, Case Reports, and Comprehensive Reviews. Perspective and insight concerning controversial subjects and evolving technologies are provided regularly through Editorial Commentaries furnished by members of the Editorial Board and other experts. Articles are subject to double-blind peer review and complete editorial evaluation prior to any decision regarding acceptability.
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