Serum adipokine and inflammatory markers before and after liver transplantation in recipients with major cardiovascular events

Abstract Background Case reports on braid-like coronary arteries, often diagnosed as Woven Coronary Artery, are accumulating. However, the diversity of manifestation of such lesions has caused great confusion. Methods Consecutive patients admitted to Fuwai hospital with braid-like lesions on coronary angiography (CAG) were included. Intracoronary optical coherence tomography (OCT) was performed to verify the lesion nature. Major cardiovascular events were recorded in 12 months when a control CAG was recommended. Results From January 2018 to June 2019, braid-like lesions were identified in 6 patients (5 male) with average age of 45.3 years. All patients were transferred from lower-level hospitals. Five patients were current heavy smokers, and 4 patients had an old anterior myocardial infarction history. The braid-like segments were found in right coronary artery of 4 patients and in left anterior descending artery of the other 2 patients. Of these 6 braid-like lesions, 3 were culprit of coronary adverse events, and the other 3 lacked relevant history or documented inducible ischemia. The OCT images of all lesions were consistent with recanalization of organized thrombi, which consisted of septa that divided the lumen into multiple small cavities communicating with each other with significant stenosis. These structures had smooth inner borders with traces of intraluminal thrombi, but no separate 3-layered structure could be defined. Drug eluting stents were successfully implanted in all braid-like lesions. All patients were event free for 12 months, and 3 patients received control CAGs which showed stents patent. Conclusions Most cases of braid-like coronary artery may be recanalization of organized thrombi rather than Woven Coronary Artery. Smoking may be a potential risk factor. Percutaneous stent implantation may be challenging but benificial in selected patients. The underlying cause of the forming of such thrombotic lesions remained unclear. Imagings before and after intervention Funding Acknowledgement Type of funding source: None

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The efficacy of a PCSK9 inhibitor for the plaque stabilization in the non-culprit lesion of ACS patients by using near-infrared intravascular ultrasonography

European Heart Journal ◽

10.1093/ehjci/ehaa946.1432 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

N Wakana ◽

K Zen ◽

K Yanishi ◽

N Nakanishi ◽

T Nakamura ◽

...

Keyword(s):

Cardiovascular Events ◽

Near Infrared ◽

Lipid Lowering ◽

Culprit Lesion ◽

Intravascular Ultrasonography ◽

Pcsk9 Inhibitor ◽

Major Cardiovascular Events ◽

Plaque Stabilization ◽

Before And After

Abstract Background and purpose In acute coronary syndrome (ACS) patients, major cardiovascular events during follow-up were equally attributable to recurrence at the site of culprit lesions and to non-culprit lesions, and mostly occurred within one year. Recent studies showed that Proprotein convertase subtilisin kexin type 9 (PCSK9) inhibitor significantly reduces the risk of cardiovascular events. However, the rigorous effects of PCSK9 inhibitor in patients with ACS, especially for the stabilization of plaque in the non-culprit lesions has not been identified. The purpose of this study was to evaluate the efficacy of a PCSK9 inhibitor for the plaque stabilization in the non-culprit lesion of ACS patients. Methods We retrospectively analyzed the 10 ACS patients (STEMI:5 cases, NSTEMI:1 case, and UAP:4 cases) who had non-culprit lesions and were injected with a PCSK9 inhibitor. We analyzed 11 non-culprit lesions before and after PSCK9 injections by using a near-infrared intravascular ultrasonography (NIRS-IVUS). Results The follow up intervals were 229.4±82.9 days. Major cardiovascular events did not occur in all patients. The serum low-density lipoprotein (LDL) cholesterol levels were significantly decreased form 128±36.7 mg/dl to 26.7±7.4 mg/dl (P<0.01; Figure 1A). There were no significant changes in percent atheroma volume before and after PCSK9 injections. However, the max lipid core burden index (LCBI) were significantly improved from 392.5±155.8 to 209.4±116 (P<0.01; Figure 1B). Although the lesion characteristics did not change in the images, by IVUS, the LCBI of the lesion was significantly decreased after PCSK9 injections. This study suggested that NIRS-IVUS had the possibility of detection for the slight changes in the plaque characteristics, which could not be detected by only an IVUS. Conclusion This study suggested that the plaque morphology can be altered by the aggressive lipid lowering therapy by using a PCSK9 inhibitor, and NIRS-IVUS can detect these plaque stabilizations of non-culprit lesion in ACS patients. The authors have no financial conflicts of interest to disclose concerning the presentation. Figure 1 Funding Acknowledgement Type of funding source: None

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