Coronary disease & ACSSecondary analysis
Nonculprit Vulnerable Plaques and Prognosis in Myocardial Infarction With Versus Without ST-Segment Elevation: A PROSPECT II Substudy
- Secondary analysis of the PROSPECT II prospective natural history study
- multicentre
Authors' conclusion
In the PROSPECT II study, the per-patient prevalence of high-risk vulnerable plaques was comparable in STEMI versus NSTEMI, as was the overall long-term incidence of nonculprit lesion-related and all major adverse cardiovascular events.
Study context
- Population
- Patients with recent MI after successful PCI of obstructive lesions, 3-vessel near-infrared spectroscopy and intravascular ultrasound imaging, 2014–2017
- Participants
- 898 patients
- Comparison
- STEMI vs non-STEMI (NSTEMI)
- STEMIn = 199
- NSTEMIn = 699reference
- Primary endpoint
- MACE arising from untreated nonculprit lesions
- Follow-up
- median 3.7-year follow-up
Primary result
Nonculprit lesion-related MACE · 4 years
Hazard ratio
1.02
95% CI 0.57–1.81
P = 0.95
By group
As reported in the abstract
Further findings
Nonculprit lesion length by IVUS
P = 0.63
Minimal lumen area by IVUS
P = 0.99
2-feature high-risk nonobstructive nonculprit plaques (lesion level)
P = 0.03
2-feature high-risk plaques (patient level)
P = 0.11
| Outcome | STEMI | NSTEMI | HR (95% CI) | P value | |
|---|---|---|---|---|---|
| All MACE · 4 years | 14.2% | 13.0% | 1.06 (0.68–1.64) | P = 0.80 | |
| 0.512Hazard ratio (log scale) |
Patients with ≥1 lesion meeting ≥1 high-risk plaque criterion (STEMI vs NSTEMI)
- Similar; plaque burden ≥70%: 63.3% vs 57.8%
- P = 0.16
- Similar; max lipid core burden index over any 4-mm segment ≥324.7: 63.3% vs 57.6%
- P = 0.15
Original publication
Summarised from the published abstract; every number is checked against it