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Morphological Findings in Typical Variant Angina Presenting as Acute Coronary Syndrome Using Optical Coherence Tomography.
MedLine Citation:
PMID:  24106746     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Coronary vasospasm causes variant angina, as well as acute myocardial infarction, ventricular tachycardia, and sudden cardiac death. We evaluated morphological changes due to vasospastic lesions, which may cause acute coronary syndrome (ACS), using a novel technique called optical coherence tomography (OCT).
METHODS: Twenty patients (40-83 years old, 19 males) with vasospasm-induced ACS who visited the emergency room because of continuous chest pain and displayed transient ST segment elevation in their electrocardiogram were enrolled in the study. None of these patients had significant coronary artery disease and all had positive results in the provocation test. OCT examinations were performed for evaluation of vasospastic lesions.
RESULTS: Intraluminal thrombi and intimal erosion were found in 6 (33.3%) and 2 patients (10%), respectively. High-sensitivity C-reactive protein levels were significantly higher in patients with microthrombi (2.66 ± 3.33 mg/L) compared with those in patients without microthrombi (0.49 ± 0.30 mg/L; P = 0.022). Serum cardiac troponin-I levels were not significantly different between patients with or without microthrombi (2.37 ± 5.31 ng/mL vs. 1.45 ± 4.68 ng/mL; P = 0.704). Other parameters, including creatinine kinase-myocardial band isoenzyme, total cholesterol, pain duration, residual stenosis, lesion length, and coronary risk factors, were not significantly different between the 2 groups.
CONCLUSION: In patients with vasospasm-induced ACS, microthrombi with or without intimal erosion are major abnormal morphologic findings of OCT examinations. However, further large-scale studies are required for validation. (J Interven Cardiol 2013;26:491-500).
Authors:
Hwan-Cheol Park; Sung Il Choi; Jae Ung Lee; Soon-Gil Kim; Jinho Shin; Hyun-Joong Kim
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Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  Journal of interventional cardiology     Volume:  26     ISSN:  1540-8183     ISO Abbreviation:  J Interv Cardiol     Publication Date:  2013 Oct 
Date Detail:
Created Date:  2013-10-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8907826     Medline TA:  J Interv Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  491-500     Citation Subset:  -    
Copyright Information:
© 2013, Wiley Periodicals, Inc.
Affiliation:
Division of Cardiology, College of Medicine, Hanyang University Guri Hospital, Guri, Republic of Korea.
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