Coronary disease & ACSCohort study
Coronary Atherosclerotic Plaque Activity and Future Coronary Events
- Prospective cohort study
- longitudinal
- international multicentre
Authors' conclusion
In this cohort study of patients with recent myocardial infarction, coronary atherosclerotic plaque activity was not associated with the primary composite end point.
Study context
- Population
- Patients aged ≥50 years with multivessel CAD and recent (within 21 days) MI, recruited September 2015 to February 2020interpretable scan
- Participants
- 704 patients
- Exposure
- High vs low coronary plaque activity
- High plaque activityn = 421
- Low plaque activityn = 283reference
- Outcome
- Cardiac death, nonfatal MI or unscheduled coronary revascularization (expanded during study conduct from cardiac death or nonfatal MI due to lower than anticipated event rates)
- Follow-up
- Median 4 years (IQR, 3-5 years)
Main finding
As reported in the abstract
Hazard ratio
1.25
95% CI 0.89–1.76
P = 0.20
High plaque activity vs Low plaque activity
HR 1.25 (95% CI 0.89–1.76); P = 0.20
- Participants experiencing the primary end point (overall): 9 cardiac death, 49 nonfatal MI, 83 unscheduled revascularizations
- 141 (20%)
Observational data: associations, not effects.
Secondary outcomes
| Outcome | High plaque activity | Low plaque activity | HR (95% CI) | P value | |
|---|---|---|---|---|---|
| Cardiac death or nonfatal MI | 11.2% | 6.7% | 1.82 (1.07–3.10) | P = 0.03 | |
| Cardiac death or nonfatal MI · adjusted | 1.76 (1.00–3.10) | P = 0.05 | |||
| All-cause mortality | 7.1% | 3.2% | 2.43 (1.15–5.12) | P = 0.02 | |
| All-cause mortality · adjusted | 2.01 (0.90–4.49) | P = 0.09 | |||
| Unscheduled revascularization | 0.98 (0.64–1.49) | P = 0.91 | |||
| 0.20.5125Hazard ratio (log scale) |
Original publication
Coronary Atherosclerotic Plaque Activity and Future Coronary Events. JAMA Cardiol. Published 1 August 2023. doi:10.1001/jamacardio.2023.1729
Summarised from the published abstract; every number is checked against it