Document Detail


Impact of culprit plaque volume and composition on myocardial microcirculation following primary angioplasty in patients with ST-segment elevation myocardial infarction: Virtual histology intravascular ultrasound analysis.
MedLine Citation:
PMID:  22481047     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: An impaired myocardial perfusion state after primary angioplasty is a strong predictor of long-term adverse outcomes in patients with STEMI. We assessed the relationship between culprit plaque characteristics and myocardial perfusion state after primary angioplasty in patients with ST-segment elevation myocardial infarction (STEMI). METHODS: A total of 101consecutive patients with de novo STEMI were divided into 3 groups according to the state of myocardial perfusion assessed by ST-segment elevation resolution (STR): Group A (complete: STR ≥70%, n=26), Group B (partial: STR<70% but ≥30%, n=55) and Group C (none: STR<30%, n=20). We analyzed plaque features by virtual histology intravascular ultrasound (VH-IVUS) and assessed the relationship between culprit plaque characteristics and STR after primary angioplasty. RESULTS: Total plaque volume was significantly higher in Group C than in Groups A and B (146.4±38.0mm(3)vs. 93.3±29.1mm(3) and 105.8±31.5mm(3), p<0.001, respectively). Necrotic core (NC) volume was also significantly higher in Group C than in Groups A and B (25.4±8.0mm(3), vs. 11.9±6.3mm(3) and 17.3±9.7mm(3), p<0.001, respectively). Analysis of receiver-operating characteristic curves revealed that total plaque volume and NC volume had the best diagnostic accuracy of all the VH-IVUS parameters to predict STR<30%. The optimal cutoff values (sensitivity/specificity) were 123.4mm(3) (75.0%/75.3%) for total plaque volume and 20.3mm(3) (75.0%/74.1%) for NC volume. CONCLUSIONS: Culprit plaque with large plaque burden and high NC volume is closely associated with poor STR after revascularization.
Authors:
Kousei Ohshima; Shuntaro Ikeda; Hisaki Kadota; Kenichi Yamane; Naoki Izumi; Kiyotaka Ohshima; Mareomi Hamada
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-3
Journal Detail:
Title:  International journal of cardiology     Volume:  -     ISSN:  1874-1754     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-4-6     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Division of Cardiology, Department of Integrated Medicine and Informatics, Ehime University Graduate School of Medicine, Tohon, Ehime, 791-0295, Japan.
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