Coronary plaque characteristics of acute myocardial infarction patients with and without previous ischemic stroke
4 affiliations
- 1Harbin Medical University
- 2Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University
- 3Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin Medical University
- 4Department of Cardiology, the First Affiliated Hospital of Dalian Medical University
Abstract
Background: Acute myocardial infarction (AMI) occurring after ischemic cerebral stroke leads to substantially worse short- and long-term outcomes, as indicated by emerging evidence. Few studies explore possible plaque features.
Methods: From September 2019 to December 2021, 1050 AMI patients were enrolled. The individuals were divided into two groups based on whether they had suffered an ischemic stroke before percutaneous coronary intervention (PCI). Patients from both groups underwent 1:1 propensity score matching (PSM) with a caliper width of 0.02. Ultimately, the final study cohort comprised 386 patients.
Results: Regarding culprit lesions, patients in the stroke group exhibited a greater prevalence of thin-cap fibroatheromas (TCFA, 70.0% vs. 55.4%, p = 0.003), macrophage accumulation (52.3% vs. 39.4%, p = 0.011), a longer lipid core length (15.3 ± 7.4 mm vs. 13.5 ± 6.4 mm, p = 0.013), and a higher lipid index (3,465.0 ± 2,135.8 vs. 2,946.4 ± 1,784.4, p = 0.011), compared to non-stroke patients. Concerning non-culprit plaques, prior stroke was significantly associated with a higher prevalence of TCFA (OR 2.08, 95% CI 1.15–3.74, p = 0.014). The clinical follow-up results revealed a significantly higher incidence of major adverse cardiovascular events in the stroke group (8.9% vs. 4.2%, p = 0.009, HR 2.61, 95% CI 1.28–5.34), along with a greater frequency of recurrent stroke (4.2% vs. 1.6%, p = 0.019, HR 3.78, 95% CI 1.23–9.30) and a higher cardiac mortality rate (5.8% vs. 1.6%, p = 0.011, HR 3.55, 95% CI 1.33–9.47) than the non-stroke group.
Conclusion: In stroke patients, coronary multivessel disease is common and characterized by high-risk plaque features and increased cardiovascular event susceptibility, with prior ischemic stroke being associated with a higher prevalence of these OCT-defined high-risk features.
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BibTeX
@article{wang2026coronary,
title = {{Coronary plaque characteristics of acute myocardial infarction patients with and without previous ischemic stroke}},
author = {Qiuping Wang and Fuhong Dong and Chao Fang and Sining Hu and Haibo Jia and Weili Pan and Lulu Li and Jianjun Wu and Luping He and Yini Wang and Tao Chen and Huai Yu and Jiannan Dai and Bo Yu},
journal = {Frontiers in Cardiovascular Medicine},
year = {2026},
month = oct,
doi = {10.3389/fcvm.2026.1798730},
url = {https://www.frontiersin.org/articles/10.3389/fcvm.2026.1798730/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Coronary plaque characteristics of acute myocardial infarction patients with and without previous ischemic stroke
AU - Qiuping Wang
AU - Fuhong Dong
AU - Chao Fang
AU - Sining Hu
AU - Haibo Jia
AU - Weili Pan
AU - Lulu Li
AU - Jianjun Wu
AU - Luping He
AU - Yini Wang
AU - Tao Chen
AU - Huai Yu
AU - Jiannan Dai
AU - Bo Yu
PY - 2026
DA - 2026/10/16
JO - Frontiers in Cardiovascular Medicine
DO - 10.3389/fcvm.2026.1798730
UR - https://www.frontiersin.org/articles/10.3389/fcvm.2026.1798730/full
AB - Background: Acute myocardial infarction (AMI) occurring after ischemic cerebral stroke leads to substantially worse short- and long-term outcomes, as indicated by emerging evidence. Few studies explore possible plaque features. Methods: From September 2019 to December 2021, 1050 AMI patients were enrolled. The individuals were divided into two groups based on whether they had suffered an ischemic stroke before percutaneous coronary intervention (PCI). Patients from both groups underwent 1:1 propensity score matching (PSM) with a caliper width of 0.02. Ultimately, the final study cohort comprised 386 patients. Results: Regarding culprit lesions, patients in the stroke group exhibited a greater prevalence of thin-cap fibroatheromas (TCFA, 70.0% vs. 55.4%, p = 0.003), macrophage accumulation (52.3% vs. 39.4%, p = 0.011), a longer lipid core length (15.3 ± 7.4 mm vs. 13.5 ± 6.4 mm, p = 0.013), and a higher lipid index (3,465.0 ± 2,135.8 vs. 2,946.4 ± 1,784.4, p = 0.011), compared to non-stroke patients. Concerning non-culprit plaques, prior stroke was significantly associated with a higher prevalence of TCFA (OR 2.08, 95% CI 1.15–3.74, p = 0.014). The clinical follow-up results revealed a significantly higher incidence of major adverse cardiovascular events in the stroke group (8.9% vs. 4.2%, p = 0.009, HR 2.61, 95% CI 1.28–5.34), along with a greater frequency of recurrent stroke (4.2% vs. 1.6%, p = 0.019, HR 3.78, 95% CI 1.23–9.30) and a higher cardiac mortality rate (5.8% vs. 1.6%, p = 0.011, HR 3.55, 95% CI 1.33–9.47) than the non-stroke group. Conclusion: In stroke patients, coronary multivessel disease is common and characterized by high-risk plaque features and increased cardiovascular event susceptibility, with prior ischemic stroke being associated with a higher prevalence of these OCT-defined high-risk features.
SN - 2297-055X
ER -