Coronary plaque characteristics of acute myocardial infarction patients with and without previous ischemic stroke.

Authors

Qiuping Wang, Fuhong Dong, Chao Fang, Sining Hu, Haibo Jia, Weili Pan, Lulu Li, Jianjun Wu, Luping He, Yini Wang, Tao Chen, Huai Yu, Jiannan Dai, Bo Yu

Published in

Frontiers in cardiovascular medicine. Volume 13. Pages 1798730. Epub Oct 16, 2026.

Abstract

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.
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.
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.
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.

PMID:
42964172
Bibliographic data and abstract were imported from PubMed on 31 Oct 2026.

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