MedStar Authors catalog › Details for: Impact of optical coherence tomography findings on clinical outcomes in ST-segment elevation myocardial infarction patients: a MATRIX (Minimizing Adverse Hemorrhagic Events by Trans-radial Access Site and angioX) OCT sub-study.
Impact of optical coherence tomography findings on clinical outcomes in ST-segment elevation myocardial infarction patients: a MATRIX (Minimizing Adverse Hemorrhagic Events by Trans-radial Access Site and angioX) OCT sub-study.
Citation: The International Journal of Cardiovascular Imaging. 37(4):1143-1150, 2021 Apr..Journal: The international journal of cardiovascular imaging.Published: ; 2021ISSN: 1569-5794.Full author list: Yacob O; Garcia-Garcia HM; Dan K; Soud M; Adamo M; Picchi A; Sardella G; Frigoli E; Limbruno U; Rigattieri S; Diletti R; Boccuzzi G; Zimarino M; Contarini M; Russo F; Calabro P; Ando G; Varbella F; Garducci S; Palmieri C; Briguori C; Kuku KO; Karagiannis A; Valgimigli M.UI/PMID: 33225426.Subject(s): IN PROCESS -- NOT YET INDEXEDInstitution(s): MedStar Washington Hospital Center | MedStar Heart & Vascular InstituteDepartment(s): Internal Medicine ResidencyActivity type: Journal Article.Medline article type(s): Journal ArticleDigital Object Identifier: https://dx.doi.org/10.1007/s10554-020-02098-8 (Click here)Abbreviated citation: Int J Cardiovasc Imaging. 37(4):1143-1150, 2021 Apr.Abstract: PURPOSE: To investigate the association of the degree of stent expansion, as assessed by optical coherence tomography (OCT), following stent implantation, and clinical outcomes in ST-segment elevation myocardial infarction (STEMI) patients.Abstract: METHODS: STEMI patients from the MATRIX (Minimizing Adverse Haemorrhagic Events by TRansradial Access Site and angioX) OCT study were selected; Clinical outcomes were collected through 1 year. Stent expansion index is a minimum stent area (MSA) divided by average lumen area (average of proximal and distal reference lumen area). The following variables were measured: MSA (< 4.5mm2), dissection (> 200 microm in width and < 5 mm from stent segment), malapposition (> 200 microm distance of stent from vessel wall), a thrombus (area > 5% of lumen area) were compared.Abstract: RESULTS: A total of 151 patients were included; after excluding patients with suboptimal OCT quality, the population with available OCT was classified into 2 groups: under-expanded < 90% (N = 72, 51%) and well-expanded >= 90% (N = 67, 49%). In the well-expanded group, a significant number of the proximal vessels had a lumen area < 4.5mm2 (16.1%, p < 0.001) and a greater thrombus burden within stent (56.7%, p = 0.042). The overall 30 day and 1 year major adverse cardiovascular event (MACE) rates were 5% and 6.1%, respectively.Abstract: CONCLUSION: Irrespective of the degree of stent expansion, the OCT findings, in STEMI patients, and the MACE at 30 days and one year follow up was low; further, well-expanded stents led to a more significant residual thrombotic burden within the stent but seemed to have insignificant clinical impact. Acknowledged stent optimization criteria, traditionally related to worse outcomes in stable patients, do not seem to be associated with worse outcomes in this STEMI population.