Angiographic evaluation of plaque volume and cardiovascular events after coronary stent implantation.

BACKGROUND Plaque volume (PV) is related to major cardiovascular events (MACE) after coronary stent implantation. OBJECTIVE To evaluate the association between PV before the procedure evaluated by angiography and clinical outcomes. METHODS This is a prospective cohort study of patients undergoing coronary stent implantation in a referral center. PV before the stent implantation was evaluated by the formula described by Giugliano (Am J Cardiol 2005, 95:173): VP = π X (lesion length) X [(vessel diameter/2)² - (minimum luminal diameter/2)²]. The MACE were registered at clinical follow-up of one year and multiple linear regression analysis was performed to identify predictors of events. RESULTS The sample consisted of 824 patients, mean age 60 ± 11 years, 70.0% were male. Diabetes mellitus was present in 21.0% and triple vessel involvement in 12.0%. Average reference diameter was 3.3 ± 3.2 mm, average lesion length was 10.2 ± 4.7 mm and mean residual stenosis was 1.0% ± 12.0%. Patients with MACE had higher PV than those without events (92.84 ± 42.85 vs 85 ± 46.85, p = 0.03). Other variables associated with MACE in the univariate analysis were triple vessel involvement, myocardial infarction, vessel diameter and length of the lesion treated. PV maintained a significant association with MACE after adjusting for the variables described and diabetes mellitus. CONCLUSION The volume of atheromatous plaque before stenting was higher in patients with MACE on clinical follow-up in one year, regardless of other predictors of events.