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Characteristics of non-culprit coronary artery lesions assessed by intravascular ultrasound in patients with ST-segment elevation myocardical infarction.

Characteristics of non-culprit coronary artery lesions assessed by intravascular ultrasound in patients with ST-segment elevation myocardical infarction.

期刊: La Clinica terapeutica 日期: 2026-07-01 PMID: 42340789 DOI: 10.7417/CT.2026.2082 浏览: 31
作者: Nguyen PA, Dinh HL, Nguyen HT, Nguyen TTH, Nguyen QT, Dat PT, Le TB, Hoang VA, Tran BH, Vu QN
PA, N., HL, D., HT, N., TTH, N., QT, N., PT, D., TB, L., VA, H., BH, T., & QN, V. (2026). Characteristics of non-culprit coronary artery lesions assessed by intravascular ultrasound in patients with ST-segment elevation myocardical infarction.. La Clinica terapeutica. https://doi.org/10.7417/CT.2026.2082
PA N, HL D, HT N, TTH N, QT N, PT D, et al. Characteristics of non-culprit coronary artery lesions assessed by intravascular ultrasound in patients with ST-segment elevation myocardical infarction.. La Clinica terapeutica. 2026; doi: 10.7417/CT.2026.2082
PA N, HL D, HT N, et al. Characteristics of non-culprit coronary artery lesions assessed by intravascular ultrasound in patients with ST-segment elevation myocardical infarction.[J]. La Clinica terapeutica. 2026. DOI: 10.7417/CT.2026.2082.
@article{pa2026,
  author = {Nguyen PA and Dinh HL and Nguyen HT and Nguyen TTH and Nguyen QT and Dat PT and Le TB and Hoang VA and Tran BH and Vu QN},
  title = {Characteristics of non-culprit coronary artery lesions assessed by intravascular ultrasound in patients with ST-segment elevation myocardical infarction.},
  journal = {La Clinica terapeutica},
  year = {2026},
  doi = {10.7417/CT.2026.2082},
  note = {PMID: 42340789},
}
TY  - JOUR
AU  - Nguyen PA
AU  - Dinh HL
AU  - Nguyen HT
AU  - Nguyen TTH
AU  - Nguyen QT
AU  - Dat PT
AU  - Le TB
AU  - Hoang VA
AU  - Tran BH
AU  - Vu QN
TI  - Characteristics of non-culprit coronary artery lesions assessed by intravascular ultrasound in patients with ST-segment elevation myocardical infarction.
T2  - La Clinica terapeutica
PY  - 2026
DO  - 10.7417/CT.2026.2082
AN  - PMID:42340789
ER  - 

摘要

BACKGROUND: Non-culprit coronary lesions are increasingly recognized as an important source of recurrent cardiovascular events in patients with ST-segment elevation myocardial infarction (STEMI). Intravascular ultrasound (IVUS) provides detailed assessment of plaque morphology; however, data in real-world STEMI populations, particularly in Vietnam, remain limited. OBJECTIVE: To characterize morphological features and associated factors of non-culprit coronary lesions using IVUS in STEMI patients. METHODS: This prospective observational study included 103 STEMI patients with multivessel disease undergoing primary percutaneous coronary intervention. A total of 118 non-culprit lesions were assessed by IVUS. High-risk plaque features were defined as the presence of at least two of the following: minimal lumen area (MLA) <4.0 mm², plaque burden ≥70%, spotty calcification, or lipid core. Clinical, lipid, and lesion-related factors associated with high-risk features were analyzed. RESULTS: High-risk plaque characteristics were common, with 66% of lesions exhibiting ≥2 high-risk features. Calcified plaques predominated (75.4%), with spotty calcification observed in 52.5% of lesions, while lipid core was less frequent (14.4%). MLA <4 mm² and plaque burden ≥70% were present in 68% and 53% of lesions, respectively. Diabetes mellitus (44.4% vs. 19.4%, p=0.015), dyslipidemia (79.4% vs. 54.2%, p=0.017), and higher non-HDL cholesterol levels (p=0.005) were significantly associated with ≥2 high-risk features. Lesions located in the left anterior descending artery were more likely to exhibit high-risk characteristics (48.1% vs. 25.6%, p=0.019). In multivariable analysis, diabetes (OR 4.40, p=0.011), non-HDL cholesterol (OR 3.40, p=0.002), and LAD location (OR 3.35, p=0.027) were independent predictors. CONCLUSIONS: Non-culprit lesions in STEMI patients frequently demonstrate multiple high-risk features on IVUS. Diabetes, non-HDL cholesterol, and LAD location are independently associated with high-risk plaque phenotypes. These findings support the role of IVUS in comprehensive risk stratification of non-culprit lesions in multivessel STEMI.

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