Document Detail


A contemporary re-evaluation of culprit lesion severity in patients presenting with STEMI.
MedLine Citation:
PMID:  23215744     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Background: Historical data report fatal myocardial infarction occurring when mildly-stenotic coronary plaques rupture; however, recent data suggest haemodynamically-significant coronary stenoses with fractional flow reserve (FFR) ≤ 0.8 and vessels with high plaque burden and minimum luminal area (MLA) < 4 mm(2) by intravascular ultrasound (IVUS) may be prognostically important. Therefore, we sought to re-evaluate culprit stenosis severity in patients presenting with ST-segment elevation myocardial infarction (STEMI). Methods: Patients undergoing primary percutaneous coronary intervention (PPCI) for STEMI with adjunctive thrombectomy between October 2008 and February 2010 (n = 336/572; 59%) underwent quantitative coronary angiography (QCA) after thrombus aspiration to determine vessel reference area (RA), MLA and percentage area stenosis (AS). To validate findings, QCA and FFR were measured in 50 patients with stable angina and an angiographically-intermediate lesion. Results: STEMI patients had anatomically-severe underlying culprit disease similar to that of the stable cohort (AS: 91.6 ± 9.5% versus 90.1 ± 8.1%; P = 0.11). Additionally, anatomically-severe lesions defined by QCA were more likely to be functionally-significant by FFR and vice-versa (P = 0.02 and 0.002 respectively). Conclusion: These contemporary data suggest that STEMI culprit lesions, defined by luminal stenosis after thrombus aspiration, are angiographically significant, with similar stenosis severity to stable, ischaemia-inducing lesions.
Authors:
Liam M McCormick; Stephen P Hoole; Adam J Brown; David P Dutka; Nick E J West
Related Documents :
24280964 - Stent thrombosis with second-generation drug-eluting stents compared with bare-metal st...
1211854 - Coronary and aortic atherosclerosis in relation to occupational physical activity in ma...
18716364 - Serum osteoprotegerin as a screening tool for coronary artery calcification score in di...
23332594 - Relation of gender to infarct size in patients with st-segment elevation myocardial inf...
9236434 - Effects of rheothrx on mortality, morbidity, left ventricular function, and infarct siz...
22726664 - Hyperacute t-waves: wolff-parkinson-white pattern or acute coronary syndrome?
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acute cardiac care     Volume:  14     ISSN:  1748-295X     ISO Abbreviation:  Acute Card Care     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101276603     Medline TA:  Acute Card Care     Country:  England    
Other Details:
Languages:  eng     Pagination:  111-6     Citation Subset:  IM    
Affiliation:
Department of Interventional Cardiology, Papworth Hospital , Cambridge , UK.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

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


Previous Document:  A comparative study of adhesion of melanoma and breast cancer cells to blood and lymphatic endotheli...
Next Document:  Consequences of misdiagnosis and mismanagement of takotsubo cardiomyopathy.