Morphological predictors for no reflow phenomenon after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction caused by plaque rupture

European Heart Journal Cardiovascular Imaging
Tsunenari SoedaIk-Kyung Jang

Abstract

Myocardial no reflow after percutaneous coronary intervention (PCI) is associated with poor outcome. Patients with ST-segment elevation myocardial infarction (STEMI) caused by plaque rupture are at high risk for no reflow. However, specific morphologic characteristics associated with no reflow are unknown in this population. The aim of this study is to identify the morphological characteristics of culprit plaques associated with no reflow in patients with STEMI caused by plaque rupture using both optical coherence tomography (OCT) and intravascular ultrasound (IVUS). We enrolled 145 patients with STEMI who underwent both OCT and IVUS within 12 h of symptom onset. Among these patients, we excluded those with plaque erosion and calcified nodule and included 72 patients who had plaque rupture as an underlying mechanism for STEMI. Myocardial no reflow, defined as Thrombolysis in Myocardial Infarction flow grade 0-2 and/or myocardial blush grade 0-1 after PCI, was observed in 28 patients (38.9%). Onset to recanalization time was similar between the groups with and without no reflow. Receiver-operating curve analysis revealed OCT-derived lipid index > 3500 [area under curve (AUC) 0.77, P < 0.001] and IVUS-derived plaque burden > 81.5...Continue Reading

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Citations

Jul 6, 2018·Current Atherosclerosis Reports·Ahmadreza Karimianpour, Anbukarasi Maran
Jun 9, 2018·American Journal of Physiology. Heart and Circulatory Physiology·Robert A KlonerMichael G Harrington
Jan 27, 2019·Journal of Personalized Medicine·Theodore G PapaioannouDimitrios Tousoulis
Aug 8, 2019·Expert Review of Cardiovascular Therapy·Jathinder KumarThomas J Kiernan
Apr 22, 2018·Echocardiography·Hae Geun SongGary S Mintz
Dec 10, 2020·The Egyptian Heart Journal : (EHJ) : Official Bulletin of the Egyptian Society of Cardiology·Raghavendra Rao KAnish Gupta
Nov 1, 2020·Atherosclerosis·Rocco VergalloFilippo Crea
Apr 8, 2021·Expert Review of Cardiovascular Therapy·Kunihiro ShimamuraTakashi Akasaka
Jul 27, 2021·Circulation Journal : Official Journal of the Japanese Circulation Society·Matthew SibbaldTej Sheth

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