This study aimed to investigate the association of high-risk culprit plaque features by optical coherence tomography (OCT) with residual SYNTAX score (rSS) and the predictive value of rSS for major adverse cardiac events (MACE) in patients with ST segment elevation myocardial infarction (STEMI). We included 274 patients and divided them into 3 groups — rSS=0 (n=72), 0<rSS≤8 (n=134), and rSS>8 (n=68). There were significant differences in plaque characteristics among three groups (plaque rupture: 44.4% versus 59.0% versus 64.7%, lowest to highest rSS, p=0.040; OCT-defined high-risk plaques: 16.7% versus 23.9% versus 35.3%, lowest to highest rSS, p=0.036; calcification: 38.9% versus 52.5% versus 61.8%, lowest to highest rSS, p=0.024). During a mean follow-up of 2.2 years, MACE occurred in 47 (17.2%) patients; rSS >8 group had higher MACE risk compared to rSS=0 (HR: 2.68, 95%CI: 1.11–6.5, P=0.029). In conclusion, culprit plaque morphology was significantly correlated with rSS, and elevated rSS was associated with higher cardiovascular risk in STEMI patients. ClinicalTrials.gov: NCT03593928

本研究旨在通过光学相干断层扫描 (OCT) 研究高危罪犯斑块特征与残余 SYNTAX 评分 (rSS) 的关系以及 rSS 对 ST 段抬高型心肌梗死患者主要不良心脏事件 (MACE) 的预测价值。 （STEMI）。我们纳入了 274 名患者并将他们分为 3 组——rSS=0 (n=72)、0<rSS≤8 (n=134) 和 rSS>8 (n=68)。三组之间的斑块特征存在显着差异（斑块破裂：44.4% vs 59.0% vs 64.7%，最低到最高 rSS，p=0.040；OCT 定义的高危斑块：16.7% vs 23.9% vs 35.3%，最低到最高 rSS，p=0.036；钙化：38.9% 对 52.5% 对 61.8%，从最低到最高 rSS，p=0.024）。在平均 2.2 年的随访期间，47 名 (17.2%) 患者发生了 MACE；RSS > 与 rSS=0 相比，第 8 组的 MACE 风险更高（HR：2.68，95%CI：1.11-6.5，P=0.029）。总之，罪魁祸首斑块形态与 rSS 显着相关，而 rSS 升高与 STEMI 患者心血管风险升高有关。ClinicalTrials.gov：NCT03593928