Document Detail

Plaque shift and distal embolism in patients with acute myocardial infarction: A volumetric intravascular ultrasound analysis from the HORIZONS-AMI trial.
MedLine Citation:
PMID:  22936619     Owner:  NLM     Status:  Publisher    
BACKGROUNDS: Vessel expansion and axial plaque redistribution or distal plaque embolization contribute to the increase in lumen dimensions after stent implantation. METHODS AND RESULTS: Pre-intervention and post-intervention grayscale volumetric intravascular ultrasound was used to study 43 de novo native coronary lesions treated with TAXUS or Express bare metal stents in the HORIZONS-AMI Trial. There was a decrease in lesion segment plaque+media (P+M) volume (-19.5±22.2mm(3) ) that was associated with a decrease in overall analysis segment (lesion plus 5mm long proximal and distal reference segments) P+M volume (-17.5±21.0mm(3) ) that was greater than the shift of plaque from the lesion to the proximal and distal reference segments (1.9±4.5mm(3) , P<0.0001). Overall analysis segment P+M volume decreased more in the angiographic thrombus (+) vs the thrombus (-) group (27.4±23.4 vs -8.9±14.3mm(3) , P=0.003), whereas plaque shift to the reference segments showed no significant difference between the two groups (1.5±5.2 vs 2.3±3.9mm(3) , P=0.590). Compared with the angiographic thrombus (-) group, patients in the thrombus (+) group more often developed no reflow (25% vs 0%, P=0.012) and had a higher pre-intervention CK-MB (P=0.011), post-intervention CK-MB (P<0.001), and peri-procedural (post-PCI minus pre-PCI) elevation of CK-MB (P=0.001). CONCLUSIONS: In acute myocardial infarction lesions there was a marked post-stenting reduction in overall plaque volume that was significantly greater in patients with angiographic thrombus than without thrombus and may have explained a greater peri-procedural rise in CK-MB. © 2012 Wiley Periodicals, Inc.
Xiaofan Wu; Akiko Maehara; Yong He; Kai Xu; Carlos Oviedo; Bernhard Witzenbichler; Alexandra J Lansky; Ovidiu Dressler; Helen Parise; Gregg W Stone; Gary S Mintz
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-31
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  -     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Wiley Periodicals, Inc.
Columbia University Medical Center, New York, NY; the Cardiovascular Research Foundation, New York, NY.
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