Impact of plaque burden and composition on coronary slow flow in ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention: intravascular ultrasound and virtual histology analysis
Autor: | Suraj Kumar, Ramesh Daggubati, Hithesh Reddy, Raghavendra Rao K, Samir Malhotra, Naindeep Kaur, Vadivelu Ramalingam, Vikas Kadiyala, Sreenivas Reddy, Jaspreet Kaur, Hariom Soni, Jeet Ram Kashyap |
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Rok vydání: | 2020 |
Předmět: |
medicine.medical_specialty
medicine.medical_treatment Myocardial Infarction Coronary Artery Disease 030204 cardiovascular system & hematology Coronary Angiography 03 medical and health sciences 0302 clinical medicine Percutaneous Coronary Intervention Internal medicine Intravascular ultrasound medicine ST segment Humans cardiovascular diseases 030212 general & internal medicine Myocardial infarction Ultrasonography Interventional medicine.diagnostic_test business.industry Percutaneous coronary intervention General Medicine Thrombolysis medicine.disease Coronary Vessels Plaque Atherosclerotic surgical procedures operative Thin-cap fibroatheroma Conventional PCI Cardiology ST Elevation Myocardial Infarction Cardiology and Cardiovascular Medicine business TIMI |
Zdroj: | Acta cardiologica. 76(6) |
ISSN: | 1784-973X |
Popis: | Aim: Coronary slow flow (SF) is an important complication of percutaneous coronary intervention (PCI) associated with poor prognosis. The aim was to assess grey-scale intravascular ultrasound (IVUS) and virtual histology (VH-IVUS) characteristics of culprit lesion in ST-elevation myocardial infarction (STEMI).Methods: A total of 295 consecutive patients with STEMI underwent coronary angiogram and IVUS. Following PCI, patients divided into two groups; SF (thrombolysis in myocardial infarction [TIMI] flow ≤ 2, n = 74) and normal flow (NF) (TIMI flow >2, n = 221). Coronary plaque burden and its composition in relation to SF were evaluated.Results: On grey-scale IVUS, the plaque area (12.3 mm2 vs. 11.5 mm2, p = .01), plaque volume (110.7 mm3 vs. 99.8 mm3, p < .001), lesion external elastic membrane (EEM) cross-sectional area (14.9 mm2 vs. 14.0 mm2, p = .011) and remodelling index (1.3 vs. 1.2, p = .043) were significantly higher in SF group. On VH-IVUS, absolute fibrous volume (48.1 mm3 vs. 41.5 mm3, p ≤ .001), fibrofatty volume (23.8 mm3 vs. 18.6 mm3, p = .015), necrotic core volume (8.3 mm3 vs. 5.5 mm3, p < .001), dense calcium volume (1.2 mm3 vs. 0.6 mm3, p = .003) and thin cap fibroatheroma either single (30.1% vs. 16.1%, p < .001) or multiple (9.6% vs. 1.8%, p < .001) were higher in SF arm. In multivariable analysis, absolute necrotic core volume (odds ratio = 1.159; 95% CI 1.030-1.305, p = .015) was the only independent predictor of SF.Conclusions: Higher necrotic core volume as detected by VH-IVUS may be a potential risk factor for the development of coronary SF phenomenon in patients with STEMI after PCI. |
Databáze: | OpenAIRE |
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