The Influence of Coronary Plaque Morphology Assessed by Optical Coherence Tomography on Final Microvascular Function After Stenting in Patients with ST-elevation Myocardial Infarction

Overview

Journal Coron Artery Dis

Specialty Cardiology & Vascular Diseases

Date 2016 Dec 8

PMID 27926579

Citations 1

Authors

Giovanni L de Maria

Niket Patel

Mathias Wolfrum

Gregor Fahrni

George Kassimis

Italo Porto

Sam Dawkins

Robin P Choudhury

John C Forfar

Bernard D Prendergast

Keith M Channon

Rajesh K Kharbanda

Hector M Garcia-Garcia

Adrian P Banning

Affiliations

Soon will be listed here.

Abstract

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 ΔATV 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 (ρ: 0.44, P: 0.03 for method I, ρ: 0.48, P: 0.02 for method II and ρ: 0.30, P: 0.06 for method III) and ΔATV (ρ: 0.41, P: 0.04 for method II and ρ: 0.44, P: 0.03 for method III).

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.

Citing Articles

Prospects for Precision Medicine in Acute Myocardial Infarction: Patient-Level Insights into Myocardial Injury and Repair.

Alkhalil M, De Maria G, Akbar N, Ruparelia N, Choudhury R J Clin Med. 2023; 12(14).

PMID: 37510783 PMC: 10380764. DOI: 10.3390/jcm12144668.

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