| Morphological characteristics of culprit atheromatic plaque are associated with coronary flow after thrombolytic therapy: new implications of optical coherence tomography from a multicenter study. | |
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MedLine Citation:
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PMID: 20488407 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: This study investigated the association between morphological characteristics of culprit atheromatic lesions as assessed by optical coherence tomography and Thrombolysis In Myocardial Infarction (TIMI) flow grade after thrombolysis in patients with ST-segment elevation myocardial infarction (STEMI). BACKGROUND: Although several variables have been found to predict coronary flow after thrombolysis in patients with STEMI, the impact of culprit lesion morphology has not been studied. METHODS: Fifty-five patients with STEMI from 3 tertiary centers that were treated with thrombolysis and underwent optical coherence tomography examination in the culprit lesion between 24 and 48 h after thrombolysis were included in the study. Patients were categorized on the basis of TIMI flow grade into patients with TIMI flow grade 3 versus TIMI flow grade < or =2. RESULTS: Patients with TIMI flow grade < or =2 had plaques with more lipid quadrants than patients with TIMI flow grade 3 (p < 0.001), and presented with greater incidence of plaque rupture (p = 0.001). Mean minimal cap thickness was greater in patients with patent arteries than in patients with impaired flow (87 +/- 26 microm vs. 48 +/- 18 microm, p < 0.0001). Minimal cap thickness was independently associated with TIMI flow grade. CONCLUSIONS: The morphological characteristics of the culprit atheromatic lesion in patients with STEMI are associated with coronary flow after thrombolysis. The lipid content, the existence of rupture, and mainly the thickness of the fibrous cap are associated with the outcome of thrombolysis. |
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Authors:
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Konstantinos Toutouzas; Elefterios Tsiamis; Antonios Karanasos; Maria Drakopoulou; Andreas Synetos; Costas Tsioufis; Dimitrios Tousoulis; Periklis Davlouros; Dimitrios Alexopoulos; Konstantina Bouki; Thomas Apostolou; Christodoulos Stefanadis |
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Publication Detail:
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Type: Journal Article; Multicenter Study |
Journal Detail:
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Title: JACC. Cardiovascular interventions Volume: 3 ISSN: 1876-7605 ISO Abbreviation: JACC Cardiovasc Interv Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-05-21 Completed Date: 2010-08-30 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101467004 Medline TA: JACC Cardiovasc Interv Country: United States |
Other Details:
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Languages: eng Pagination: 507-14 Citation Subset: IM |
Copyright Information:
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Copyright 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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First Department of Cardiology, Athens Medical School, Hippokration Hospital, Athens, Greece. ktoutouz@otenet.gr |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Chi-Square Distribution Coronary Angiography Coronary Artery Disease / drug therapy, pathology*, physiopathology Coronary Circulation / drug effects* Coronary Thrombosis / drug therapy, pathology*, physiopathology Female Fibrinolytic Agents / therapeutic use* Fibrosis Greece Humans Lipids / analysis Logistic Models Male Middle Aged Myocardial Infarction / drug therapy, pathology*, physiopathology Predictive Value of Tests Prospective Studies Rupture Thrombolytic Therapy* Tissue Plasminogen Activator / therapeutic use* Tomography, Optical Coherence* Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Fibrinolytic Agents; 0/Lipids; 0/tenecteplase; EC 3.4.21.68/Tissue Plasminogen Activator |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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