Impact of plaque color by angioscopic evaluation on long-term clinical outcomes in patients with acute myocardial infarction undergoing percutaneous coronary intervention

Objective: This study assessed the relationship of in vivo plaque color in the culprit lesion by coronary angioscopy (CAS) with the long-term clinical outcome in patients after percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI). Methods: Consecutive 224 patients with AMI were enrolled in the present study. The culprit lesions immediately before PCI were examined by CAS and were classified into three groups according to the color grade of the plaques: thick yellow plaque (TYP), yellow plaque (YP), or light yellow plaque (LYP). Results: There were no differences in baseline lipid and glycemic profiles and other coronary risk factors among the three groups. During the follow-up at a median of 4.9 years, the incidence of major adverse cardiac event (MACE) was significantly less in patients with TYP than those with YP or LYP by Kaplan-Meier analysis (p = 0.027). TYP was an independent predictor for long-term MACE after adjustment of predictive factors (age, multivessel coronary artery disease, ejection fraction and body mass index, etc.). Conclusion: These results suggest that the TYP in culprit lesions was independently associated with the long-term favorable prognosis after AMI in patients treated with PCI. This relationship might provide new insights for pathophysiology of AMI and prevention of the secondary cardiac events after AMI. (C) 2010 Elsevier Ireland Ltd. All rights reserved.