Incidence, Predictors, and Outcome of Plaque Prolapse after Stent Implantation in Patients with Acute Myocardial Infarction: An Intravascular Ultrasound Analysis Young Joon Hong, MD, PhD; Myung Ho Jeong, MD, PhD, FACC, FAHA, FESC, FSCAI; Youngkeun Ahn, MD, PhD, FACC, FSCAI; Doo Sun Sim, MD; Jong Won Chung, MD; Jung Sun Cho, MD; Nam Sik Yoon, MD; Hyun Ju Yoon, MD; Jae Youn Moon, MD; Kye Hun Kim, MD, PhD; Hyung Wook Park, MD, PhD; Ju Han Kim, MD, PhD; Jeong Gwan Cho, MD, PhD, FACC; Jong Chun Park, MD, PhD; Jung Chaee Kang, MD, PhD The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea
33
Embed
Incidence, Predictors, and Outcome of Plaque Prolapse after Stent Implantation in Patients with Acute Myocardial Infarction: An Intravascular Ultrasound.
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
Incidence, Predictors, and Outcome of Plaque Prolapse after Stent Implantation in Patients
with Acute Myocardial Infarction: An Intravascular Ultrasound Analysis
Young Joon Hong, MD, PhD; Myung Ho Jeong, MD, PhD, FACC, FAHA, FESC, FSCAI;
Youngkeun Ahn, MD, PhD, FACC, FSCAI; Doo Sun Sim, MD; Jong Won Chung, MD; Jung
Sun Cho, MD; Nam Sik Yoon, MD; Hyun Ju Yoon, MD; Jae Youn Moon, MD; Kye Hun Kim,
MD, PhD; Hyung Wook Park, MD, PhD; Ju Han Kim, MD, PhD; Jeong Gwan Cho, MD, PhD,
FACC; Jong Chun Park, MD, PhD; Jung Chaee Kang, MD, PhD
The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea
● Coronary angiography
-- provides only simple, planar projections of three-
dimensional coronary lumen anatomy.
-- is limited to detect intrastent plaque prolapse (PP).
● Previous studies have shown that
-- PP is not a rare phenomenon.
-- PP has been detected frequently by intravascular
ultrasound (IVUS).
Background (I)
● It has been known that several pre-intervention IVUS
factors and aggressive stenting procedure have been
associated with PP.
● Some studies have demonstrated that PP was associated
with stent thrombosis.
● However, data on the characteristics of PP in patients
with acute myocardial infarction (AMI) are lacking.
Background (II)
Objectives
● to assess the incidence, predictors, and outcome of PP
after stent implantation for infarct-related arteries in
AMI patients.
● a total of 310 patients with a first AMI
- 125 ST segment elevation and 185 non-ST segment
elevation MI
- From January 9, 2001 to July 31, 2007
- who underwent pre-intervention IVUS within 24 hours from
symptom onset
- were stented successfully
- had post-intervention IVUS imaging
Patient Population (I)
Patient Population (II)
● Exclusion
- prior MI, subacute or late stent thrombosis, restenosis
after stenting, coronary artery bypass graft failure, patients
studied with IVUS more than 24 hours after symptom
onset,
and patients in whom adequate IVUS images could not be
obtained
● Identification of infarct-related arteries
- electrocardiographic findings
- left ventricular wall motion abnormalities on left ventricular
angiogram or echocardiogram
- coronary angiographic findings
Laboratory Analysis● Venous blood samples were obtained within 24 hours after
stenting.
● The blood samples were centrifuged, and serum was
removed and stored at -70°C until the assay could be
performed.
● Absolute creatine kinase-MB (CK-MB) levels were
determined by radioimmunoassay (Dade Behring Inc., Miami,
Florida).
● Cardiac-specific troponin I (cTnI) levels were measured by a