Age-related differences in intravascular ultrasound findings in 1,009 coronary artery disease patients

Background: The aim of this study was to assess the age-related differences in intravascular ultrasound (IVUS) findings of target lesions in patients with coronary artery disease, Methods and Results: The 1,009 patients who underwent IVUS imaging were grouped according to an increase of 10 years of age: Group I [<50 years (n=144)]; Group II [51-60 years (n=259)]; Group III [61-70 years (n=249)]; Group IV [71-80 years (n=264)]; and Group V [>80 years, (n=93)]. Calcified plaque (18%, 25%, 33%, 38%, and 46%, p<0.001) and negative remodeling (29%, 48%, 44%, 44%, and 66%, p<0.001) were most common, and reference segment plaque burden (35±11%, 35±10%, 39±10%, 38±10%, and 40±11%, p<0.001) was greatest in Group V. Plaque rupture (52%, 31%, 42%, 38%, and 20%, p=0.009) and thrombus (38%, 30%, 31%, 24%, and 11%, p=0.026) were most common in Group I. In the multiple logistic regression analysis, patient age was an independent predictor of calcified plaque (odds ratio (OR)=1.03, p=0.001), negative remodeling (OR= 1.04, p=0.001), and mean reference segment plaque burden >50% (OR=l .03, p=0.006). Conclusion Elderly patients have more severe calcifications with negative remodeling and diffuse atherosclerosis, whereas younger patients have more unstable plaque morphology.