Impact of non-culprit lesion thin-cap fibroatheroma (TCFA) on adverse cardiovascular events in patients with diabetes mellitus who present with acute myocardial infarction
Authors' conclusion
DM patients have a higher incidence of NCL-MACE after AMI, primarily due to increased NCL TCFA prevalence. In both DM and non-DM patients, NCL TCFA worsens long-term prognosis.
Study context
- Population
- Acute myocardial infarction (AMI) patients undergoing three-vessel optical coherence tomography
- Participants
- 1,312 patients
- Exposure
- Diabetes mellitus (DM) vs non-DM; NCL TCFA vs no TCFA
- DMn = 311
- Outcome
- NCL-MACE:
- Cardiac death
- Non-fatal myocardial infarction (MI)
- Unplanned coronary revascularization
- Follow-up
- Median 4.1 years (IQR: 3.0-5.0 years)
Methodological detailsthree-vessel optical coherence tomography (OCT)
- Three-vessel OCT
Main finding
As reported in the abstract
NCL-MACE · median 4.1 years
DM vs Non-DMEstimate (95% CI)
NCL-MACE
HR 2.10(1.23–3.57)
After adjusting for TCFA
adjusted HR 1.66(0.94–2.94)
Observational data: associations, not effects.
Further findings
NCL TCFA prevalence, patient level
P < 0.001
NCL TCFA prevalence, lesion level
P < 0.001
| Outcome | DM | Non-DM | Estimate | |
|---|---|---|---|---|
| Non-fatal MI (NCL) | 3.7% | 1.0% | HR 3.33 (95% CI 1.25–8.87) | |
| Association of DM with TCFA | adjusted OR 1.61 (95% CI 1.22–2.13) | |||
| 0.10.31310Ratio (log scale) |
Original publication
Impact of non-culprit lesion TCFA on adverse cardiovascular events in patients with diabetes mellitus who present with acute myocardial infarction. Eur Heart J Cardiovasc Imaging. Published 28 July 2025. doi:10.
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