Association of Intravascular Ultrasound- and Optical Coherence Tomography-Assessed Coronary Plaque Morphology With Periprocedural Myocardial Injury in Patients With Stable Angina Pectoris.
Circ J
; 79(9): 1944-53, 2015.
Article
em En
| MEDLINE
| ID: mdl-26095152
ABSTRACT
BACKGROUND:
Periprocedural myocardial injury (PMI) is not an uncommon complication and is related to adverse cardiac events after percutaneous coronary intervention (PCI). We investigated the predictors of PMI in patients with stable angina pectoris (SAP) on intravascular imaging. METHODSâANDâRESULTS:
We enrolled 193 SAP patients who underwent pre-PCI intravascular ultrasound (IVUS) and optical coherence tomography (OCT). Clinical characteristics, lesion morphology, and long-term follow-up data were compared between patients with and without PMI, defined as post-PCI elevation of high-sensitivity cardiac troponin-T. PMI were observed in 79 patients (40.9%). Estimated glomerular filtration rate (odds ratio [OR], 0.973; 95% confidence interval [CI] 0.950-0.996; P=0.020), ≥2 stents (OR, 3.100; 95% CI 1.334-7.205; P=0.009), final myocardial blush grade 0-2 (OR, 4.077; 95% CI 1.295-12.839; P=0.016), and IVUS-identified echo-attenuated plaque (EA; OR, 3.623; 95% CI 1.700-7.721; P<0.001) and OCT-derived thin-cap fibroatheroma (OCT-TCFA; OR, 3.406; 95% CI 1.307-8.872; P=0.012) were independent predictors of PMI on multivariate logistic regression analysis. A combination of EA and OCT-TCFA had an 82.4% positive predictive value for PMI. On Cox proportional hazards analysis, PMI was an independent predictor of adverse cardiac events during 1-year follow-up (hazard ratio, 2.984; 95% CI 1.209-7.361; P=0.018).CONCLUSIONS:
Plaque morphology assessment using pre-PCI IVUS and OCT may be useful for predicting PMI in SAP patients.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Doença da Artéria Coronariana
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Ultrassonografia de Intervenção
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Tomografia de Coerência Óptica
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Placa Aterosclerótica
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Angina Estável
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Traumatismos Cardíacos
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Miocárdio
Tipo de estudo:
Etiology_studies
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Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Circ J
Assunto da revista:
ANGIOLOGIA
/
CARDIOLOGIA
Ano de publicação:
2015
Tipo de documento:
Article