The purpose of this study is to perform pooled analysis with data collected from 5 previously published studies and 8 unpublished datasets collected from international sites. The main goal of this study is to identify the predictors of plaque erosion.
Plaque erosion is reported to be responsible for about one third of patients with acute coronary syndrome (ACS). In the EROSION study, we reported that antithrombotic therapy without stenting achieved a reduction in thrombus volume greater than 50% in over 70% of patients diagnosed with ACS caused by plaque erosion. This result suggests that the conservative approach of anti-thrombotic therapy without stenting may be an option for patients diagnosed with ACS caused by plaque erosion, which may be the paradigm shift in treatment of ACS patients. However, at present, the only way to make an in vivo diagnosis of plaque erosion is intra-coronary optical coherence tomography (OCT). If we can identify clinical factors associated with plaque erosion, we may be able to narrow down a sub-population of patients with a higher likelihood of plaque erosion. This group of patients may be stabilized with pharmacologic therapy and avoid invasive procedures, thereby preventing related complications and reducing health care burden. However, specific demographic characteristics of the ACS patients with plaque erosion are not known. Our group has the world's largest dataset of patients with plaque erosion and several published reports on plaque erosion. However, the study population of each study is still small and unbalanced to identify the demographic characteristics associated with plaque erosion. Therefore, we propose to pool data from a large number of institutions around the world. This will provide an opportunity to identify factors associated with plaque erosion.
Study Type
OBSERVATIONAL
Enrollment
1,793
Massachusetts General Hospital
Boston, Massachusetts, United States
Cardiac death
Time frame: 3-year
all cause death
Time frame: 3-year
myocardial infarction
Time frame: 3-year
stent thrombosis
stent thrombosis was defined according to the Academic Research Consortium criteria
Time frame: 3-year
any target lesion revascularization
Any revascularization due to thrombosis or restenosis of the target lesion
Time frame: 3-year
clinically driven target lesion revascularization
target lesion revascularization performed because of ischemic symptoms, electrocardiographic changes at rest or positive stress test relists
Time frame: 3-year
target-vessel revascularization
Revascularization of any segment of the coronary artery containing the target lesion
Time frame: 3-year
any repeat revascularization
Time frame: 3-year
stroke
Time frame: 3-year
device-oriented composite (cardiac death, target vessel MI, and TLR)
Time frame: 3-year
bleeding complication
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Gusto and BARC definition
Time frame: 3-year
patients-oriented composite (all cause death, MI, any repeat coronary revascularization)
Time frame: 3-year
target vessel failure (TVF; cardiac death, MI, or ischemia-driven TVR)
Time frame: 3-year
major adverse cardiac events (MACEs: cardiac death, MI, or ischemia-driven TLR)
Time frame: 3-year