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The Society for Cardiovascular Angiography and Interventions
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ID: B-057
Session Title/Time/Location:
Poster Session B/Thursday, May 29, 2014, 8:00 am 11:00 am (Pacific Time)/Exhibition Hall
Comparison of Coronary Atherosclerotic Plaque Burden and
Composition of Culprit Lesions between Cigarette smokers
and Non-Smokers by in-vivo Virtual Histology Intravascular
Ultrasound
Category: Intravascular Imaging (IVUS/OCT/NIR/Other) and Physiology (FFR/iFR/IMR/other)
Authors: Oluwaseyi Bolorunduro, University of Tennessee In Memphis/Methodist Lebonheur,
United States; Colette Cushman, Medical College Of Georgia, United States; Deepak Kapoor,
Medical College Of Georgia, United States; Kelsey Alexander, University Of Tennessee /Le
Bonheur Children's Medical Center, United States; Jose Cuellar-Silva, Medical College Of
Georgia, United States; Vincent Robinson, Medical College Of Georgia, United States; Uzoma
Ibebuogu, University of Tennessee In Memphis/Methodist Lebonheur, United States
Background: Cigarette smoking is a major risk factor in the progression of atherosclerosis and
has been shown to cause endothelial dysfunction, inflammation and modification of lipid
profile. However, its role in the pathogenesis of vulnerable coronary plaque, which has been
implicated in the acute coronary syndromes (ACS), remains unknown.
Methods: Data from consecutive patients who underwent clinically indicated cardiac
catheterization at our institution over a one-year period. Virtual histology intravascular
ultrasound assessment of the de novo native coronary artery stenosis was performed. Baseline
demographic and study characteristics were collected on all patients. Coronary plaque
compositions of the culprit lesion were compared on bivariate and Multivariate analysis using
STATA MP version 10.
Results: We collected data on 160 patients with a mean age of 60 ± 11 years. Male patients
accounted for 60% of the population, 31% were smokers, 36% of the patients had Diabetes, of
which 38% were insulin treated. 74% had hyperlipidemia, 93% of which were treated with
medications. The mean BMI was 30.6 with 42% of the population being obese. 69% of these
patients were admitted for ACS. The target vessel was the left anterior descending coronary
artery in 54% of cases. The mean plaque burden was 66%. On average, 58% of these plaques
were fibrous, 19% was fibro fatty, 18.3 % had a necrotic core and 5.4% was composed of dense
calcium. Cigarette smokers had a higher burden of necrotic core (20.7 vs. 17.2%, P=0.04). On
multivariate analysis after controlling for Age, sex, lipid profile, BMI and Diabetes mellitus,
cigarette smoking was independently associated with a 4.62% increase in the burden of
necrotic core (P=0.02). Older age (>65 years) was also a predictor of higher necrotic core
burden (p=0.03). Notably, diabetes mellitus in this population did not predict a significantly
higher burden of necrotic core (19.2% vs. 17.8 % P=0.44).
Conclusions: Cigarette smoking is associated with a higher burden of necrotic core in coronary
atherosclerotic plaques. This may represent one of the mechanisms for increased
cardiovascular events in smokers. Randomized control trials are warranted to further
investigate our findings.
Author Disclosures:
1. Oluwaseyi Bolorunduro: This author has nothing to disclose.
2. Colette Cushman: This author has nothing to disclose.
3. Deepak Kapoor: This author has nothing to disclose.
4. Kelsey Alexander: This author has nothing to disclose.
5. Jose Cuellar-Silva: This author has nothing to disclose.
6. Vincent Robinson: This author has nothing to disclose.
7. Uzoma Ibebuogu: This author has nothing to disclose.