| Plaque shift and distal embolism in patients with acute myocardial infarction: A volumetric intravascular ultrasound analysis from the HORIZONS-AMI trial. | |
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MedLine Citation:
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PMID: 22936619 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: JOURNAL ARTICLE Date: 2012-8-31 |
Journal Detail:
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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:
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Created Date: 2012-8-31 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100884139 Medline TA: Catheter Cardiovasc Interv Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 Wiley Periodicals, Inc. |
Affiliation:
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Columbia University Medical Center, New York, NY; the Cardiovascular Research Foundation, New York, NY. |
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