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Atherosclerotic plaque with ultrasonic attenuation affects coronary reflow and infarct size in patients with acute coronary syndrome: an intravascular ultrasound study.
- Source :
-
Circulation journal : official journal of the Japanese Circulation Society [Circ J] 2007 May; Vol. 71 (5), pp. 648-53. - Publication Year :
- 2007
-
Abstract
- Background: No reflow following percutaneous coronary intervention (PCI) is a major concern in patients with acute coronary syndrome (ACS) and it may be influenced by the preexisting plaque type.<br />Methods and Results: To evaluate the impact of plaque characteristics on coronary reflow following PCI in patients with ACS, a total of 110 patients (89 acute myocardial infarction, 21 unstable angina) were assessed by intravascular ultrasound. Plaque type was categorized as either atherosclerotic plaque without ultrasonic attenuation (group 1) or atherosclerotic plaque with attenuation (group 2). External elastic membrane, plaque plus media, and lumen area were measured. Coronary flow was assessed by Thrombolysis in Myocardial Infarction (TIMI) grade and TIMI frame count. Although the final TIMI frame count was similar between the 2 groups, TIMI frame count immediately after the first balloon inflation was significantly higher in group 2 (p=0.03). Despite the similar final TIMI grade and TIMI frame count, peak creatine kinase level was significantly higher (3,035+/-2,553 vs 1,950+/-1,958 IU/L, p=0.04) and fatal arrhythmia more frequently observed (16.4% vs 2.7%, p=0.04) in group 2 than in group 1.<br />Conclusions: Atherosclerotic plaque with ultrasonic attenuation may be related to a transient deterioration in coronary flow and as a result larger infarct size and higher incidence of fatal arrhythmia following PCI in patients with ACS. These results may help in selecting lesions suitable for distal protection devices.
- Subjects :
- Acute Disease
Aged
Coronary Artery Disease complications
Coronary Artery Disease therapy
Female
Humans
Male
Middle Aged
Myocardial Infarction etiology
Stents
Syndrome
Angioplasty, Balloon, Coronary
Coronary Angiography
Coronary Artery Disease diagnostic imaging
Coronary Artery Disease physiopathology
Coronary Circulation
Coronary Disease complications
Myocardial Infarction diagnostic imaging
Ultrasonography, Interventional
Subjects
Details
- Language :
- English
- ISSN :
- 1346-9843
- Volume :
- 71
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Circulation journal : official journal of the Japanese Circulation Society
- Publication Type :
- Academic Journal
- Accession number :
- 17456986
- Full Text :
- https://doi.org/10.1253/circj.71.648