Document Detail


Serial intravascular ultrasonic study of outcomes of coronary culprit lesions with plaque rupture following bare metal stent implantation in patients with angina pectoris.
MedLine Citation:
PMID:  17493467     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Coronary culprit lesions with plaque rupture (PR) have been treated with different coronary interventions. However, it is unknown whether the presence of PR affects the restenotic process after coronary intervention. One hundred forty-two patients undergoing coronary bare metal stent implantation were enrolled in the present retrospective analysis. Case selection was based on availability of intravascular ultrasound (IVUS) and quantitative coronary angiographic examinations at baseline (before and after intervention) and at follow-up. Serial comparative analyses included qualitative and quantitative features of the culprit lesion and reference segments. PR was defined as an intraplaque cavity in communication with the lumen in the presence of a residual, disrupted cap. Patients were categorized according to the presence/absence of PR. Pre-interventional IVUS detected PR in 54 patients (38%). Baseline patient demographics were similar between the +PR and -PR groups. Quantitative IVUS analysis showed higher rates of positive remodeling and larger vessel and plaque areas in the +PR compared with -PR lesions (p <0.001 for all). At follow-up (7.2 +/- 2.6 months), no statistically significant difference was observed between the 2 groups in quantitative coronary angiographic or IVUS measurements. In conclusion, culprit lesions with PR exhibited larger plaque mass and higher rates of positive remodeling at preintervention IVUS examination. However, when treated with bare metal stents, the absence/presence of preintervention PR was not found to affect the rate or severity of in-stent restenosis in these culprit lesions.
Authors:
Seung-Ho Hur; Ali H M Hassan; Rachna Rekhi; Junya Ako; Yoshihisa Shimada; Mamoo Nakamura; Masao Yamasaki; Heidi N Bonneau; Krishnankutty Sudhir; Paul G Yock; Yasuhiro Honda; Peter J Fitzgerald
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Publication Detail:
Type:  Journal Article     Date:  2007-03-28
Journal Detail:
Title:  The American journal of cardiology     Volume:  99     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-05-11     Completed Date:  2007-08-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1394-8     Citation Subset:  AIM; IM    
Affiliation:
Center for Research in Cardiovascular Interventions, Stanford University Medical Center, Stanford, CA, USA.
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MeSH Terms
Descriptor/Qualifier:
Angina Pectoris / surgery*
Blood Vessel Prosthesis Implantation / adverse effects,  instrumentation
Coronary Angiography
Coronary Restenosis / etiology*,  radiography,  ultrasonography*
Coronary Vessels / injuries,  ultrasonography
Female
Follow-Up Studies
Heart Injuries / etiology*,  radiography,  ultrasonography*
Humans
Male
Middle Aged
Postoperative Period
Prosthesis Failure
Research Design
Retrospective Studies
Stents / adverse effects*
Treatment Outcome
Ultrasonography, Interventional*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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