The influence of coronary plaque morphology assessed by optical coherence tomography on final microvascular function after stenting in patients with ST-elevation myocardial infarction.

MedStar author(s):
Citation: Coronary Artery Disease. 28(3):198-208, 2017 MayPMID: 27926579Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Angioplasty, Balloon, Coronary/is [Instrumentation] | *Coronary Circulation | *Coronary Vessels/dg [Diagnostic Imaging] | *Microcirculation | *Plaque, Atherosclerotic | *ST Elevation Myocardial Infarction/th [Therapy] | *Stents | *Tomography, Optical Coherence | Aged | Angioplasty, Balloon, Coronary/ae [Adverse Effects] | Cardiac Catheterization | Coronary Angiography | Coronary Vessels/pa [Pathology] | Coronary Vessels/pp [Physiopathology] | Electrocardiography | Female | Humans | Male | Middle Aged | Predictive Value of Tests | Prospective Studies | ST Elevation Myocardial Infarction/dg [Diagnostic Imaging] | ST Elevation Myocardial Infarction/pa [Pathology] | ST Elevation Myocardial Infarction/pp [Physiopathology] | Time Factors | Treatment Outcome | Vascular ResistanceYear: 2017Local holdings: Available online from MWHC library: February 2000 - presentISSN:
  • 0954-6928
Name of journal: Coronary artery diseaseAbstract: CONCLUSION: IMR measured before stenting is independent of the appearances of the culprit coronary plaque within the infarct-related artery. IMR after stenting, and more importantly, the change in IMR after stenting, reflect the degree of distal embolization during stent implantation.OBJECTIVES: The index of microcirculatory resistance (IMR) provides a reproducible assessment of the status of coronary microvasculature in patients with ST-elevation myocardial infarction (STEMI). Frequency-domain optical coherence tomography (FD-OCT) enables detailed assessment of the morphology of coronary plaque.We sought to determine the influence of the initial culprit coronary plaque anatomy within the infarct-related artery on IMR after stenting in STEMI.PATIENTS AND METHODS: In 25 STEMI patients IMR was measured immediately before and after stent implantation. FD-OCT imaging was performed at the same time points and atherothrombotic volume (ATV) before stenting, prolapsed+floating ATV after stenting and DELTAATV was measured using three different strategies.RESULTS: There were no relationships between preprocedural IMR and FD-OCT parameters. Prestenting IMR was related only to pain to wire time (P: 0.02). Irrespective of the method adopted, the final IMR was related to prestenting ATV (p: 0.44, P: 0.03 for method I, p: 0.48, P: 0.02 for method II and p: 0.30, P: 0.06 for method III) and DELTAATV (p: 0.41, P: 0.04 for method II and p: 0.44, P: 0.03 for method III).All authors: Banning AP, Channon KM, Choudhury RP, Dawkins S, De Maria GL, Fahrni G, Forfar JC, Garcia-Garcia HM, Kassimis G, Kharbanda RK, Patel N, Porto I, Prendergast BD, Wolfrum MFiscal year: FY2017Digital Object Identifier: Date added to catalog: 2017-05-06
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 27926579 Available 27926579

Available online from MWHC library: February 2000 - present

CONCLUSION: IMR measured before stenting is independent of the appearances of the culprit coronary plaque within the infarct-related artery. IMR after stenting, and more importantly, the change in IMR after stenting, reflect the degree of distal embolization during stent implantation.

OBJECTIVES: The index of microcirculatory resistance (IMR) provides a reproducible assessment of the status of coronary microvasculature in patients with ST-elevation myocardial infarction (STEMI). Frequency-domain optical coherence tomography (FD-OCT) enables detailed assessment of the morphology of coronary plaque.We sought to determine the influence of the initial culprit coronary plaque anatomy within the infarct-related artery on IMR after stenting in STEMI.

PATIENTS AND METHODS: In 25 STEMI patients IMR was measured immediately before and after stent implantation. FD-OCT imaging was performed at the same time points and atherothrombotic volume (ATV) before stenting, prolapsed+floating ATV after stenting and DELTAATV was measured using three different strategies.

RESULTS: There were no relationships between preprocedural IMR and FD-OCT parameters. Prestenting IMR was related only to pain to wire time (P: 0.02). Irrespective of the method adopted, the final IMR was related to prestenting ATV (p: 0.44, P: 0.03 for method I, p: 0.48, P: 0.02 for method II and p: 0.30, P: 0.06 for method III) and DELTAATV (p: 0.41, P: 0.04 for method II and p: 0.44, P: 0.03 for method III).

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