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Impact of plaque components on no-reflow phenomenon after stent deployment in patients with acute coronary syndrome: a virtual histology-intravascular ultrasound analysis

AIMS: We used virtual histology-intravascular ultrasound (VH-IVUS) to evaluate the relation between coronary plaque characteristics and no-reflow in acute coronary syndrome (ACS) patients. METHODS AND RESULTS: A total of 190 consecutive ACS patients were imaged using VH-IVUS and analysed retrospecti...

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Autores principales: Hong, Young Joon, Jeong, Myung Ho, Choi, Yun Ha, Ko, Jum Suk, Lee, Min Goo, Kang, Won Yu, Lee, Shin Eun, Kim, Soo Hyun, Park, Keun Ho, Sim, Doo Sun, Yoon, Nam Sik, Youn, Hyun Ju, Kim, Kye Hun, Park, Hyung Wook, Kim, Ju Han, Ahn, Youngkeun, Cho, Jeong Gwan, Park, Jong Chun, Kang, Jung Chaee
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3155758/
https://www.ncbi.nlm.nih.gov/pubmed/19228713
http://dx.doi.org/10.1093/eurheartj/ehp034
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author Hong, Young Joon
Jeong, Myung Ho
Choi, Yun Ha
Ko, Jum Suk
Lee, Min Goo
Kang, Won Yu
Lee, Shin Eun
Kim, Soo Hyun
Park, Keun Ho
Sim, Doo Sun
Yoon, Nam Sik
Youn, Hyun Ju
Kim, Kye Hun
Park, Hyung Wook
Kim, Ju Han
Ahn, Youngkeun
Cho, Jeong Gwan
Park, Jong Chun
Kang, Jung Chaee
author_facet Hong, Young Joon
Jeong, Myung Ho
Choi, Yun Ha
Ko, Jum Suk
Lee, Min Goo
Kang, Won Yu
Lee, Shin Eun
Kim, Soo Hyun
Park, Keun Ho
Sim, Doo Sun
Yoon, Nam Sik
Youn, Hyun Ju
Kim, Kye Hun
Park, Hyung Wook
Kim, Ju Han
Ahn, Youngkeun
Cho, Jeong Gwan
Park, Jong Chun
Kang, Jung Chaee
author_sort Hong, Young Joon
collection PubMed
description AIMS: We used virtual histology-intravascular ultrasound (VH-IVUS) to evaluate the relation between coronary plaque characteristics and no-reflow in acute coronary syndrome (ACS) patients. METHODS AND RESULTS: A total of 190 consecutive ACS patients were imaged using VH-IVUS and analysed retrospectively. Angiographic no-reflow was defined as TIMI flow grade 0, 1, and 2 after stenting. Virtual histology-intravascular ultrasound classified the colour-coded tissue into four major components: fibrotic, fibro-fatty, dense calcium, and necrotic core (NC). Thin-cap fibroatheroma (TCFA) was defined as focal, NC-rich (≥10% of the cross-sectional area) plaques being in contact with the lumen in a plaque burden ≥40%. Of the 190 patients studied at pre-stenting, no-reflow was observed in 24 patients (12.6%) at post-stenting. The absolute and %NC areas at the minimum lumen sites (1.6 ± 1.2 vs. 0.9 ± 0.8 mm(2), P < 0.001, and 24.5 ± 14.3 vs. 16.1 ± 10.6%, P = 0.001, respectively) and the absolute and %NC volumes (30 ± 24 vs. 16 ± 17 mm(3), P = 0.001, and 22 ± 11 vs. 14 ± 8%, P < 0.001, respectively) were significantly greater, and the presence of at least one TCFA and multiple TCFAs within culprit lesions (71 vs. 36%, P = 0.001, and 38 vs. 15%, P = 0.005, respectively) was significantly more common in the no-reflow group compared with the normal-reflow group. In the multivariable analysis, %NC volume was the only independent predictor of no-reflow (odds ratio = 1.126; 95% CI 1.045–1.214, P = 0.002). CONCLUSION: In ACS patients, post-stenting no-reflow is associated with plaque components defined by VH-IVUS analysis with larger NC and more TCFAs.
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spelling pubmed-31557582011-08-15 Impact of plaque components on no-reflow phenomenon after stent deployment in patients with acute coronary syndrome: a virtual histology-intravascular ultrasound analysis Hong, Young Joon Jeong, Myung Ho Choi, Yun Ha Ko, Jum Suk Lee, Min Goo Kang, Won Yu Lee, Shin Eun Kim, Soo Hyun Park, Keun Ho Sim, Doo Sun Yoon, Nam Sik Youn, Hyun Ju Kim, Kye Hun Park, Hyung Wook Kim, Ju Han Ahn, Youngkeun Cho, Jeong Gwan Park, Jong Chun Kang, Jung Chaee Eur Heart J Clinical Research AIMS: We used virtual histology-intravascular ultrasound (VH-IVUS) to evaluate the relation between coronary plaque characteristics and no-reflow in acute coronary syndrome (ACS) patients. METHODS AND RESULTS: A total of 190 consecutive ACS patients were imaged using VH-IVUS and analysed retrospectively. Angiographic no-reflow was defined as TIMI flow grade 0, 1, and 2 after stenting. Virtual histology-intravascular ultrasound classified the colour-coded tissue into four major components: fibrotic, fibro-fatty, dense calcium, and necrotic core (NC). Thin-cap fibroatheroma (TCFA) was defined as focal, NC-rich (≥10% of the cross-sectional area) plaques being in contact with the lumen in a plaque burden ≥40%. Of the 190 patients studied at pre-stenting, no-reflow was observed in 24 patients (12.6%) at post-stenting. The absolute and %NC areas at the minimum lumen sites (1.6 ± 1.2 vs. 0.9 ± 0.8 mm(2), P < 0.001, and 24.5 ± 14.3 vs. 16.1 ± 10.6%, P = 0.001, respectively) and the absolute and %NC volumes (30 ± 24 vs. 16 ± 17 mm(3), P = 0.001, and 22 ± 11 vs. 14 ± 8%, P < 0.001, respectively) were significantly greater, and the presence of at least one TCFA and multiple TCFAs within culprit lesions (71 vs. 36%, P = 0.001, and 38 vs. 15%, P = 0.005, respectively) was significantly more common in the no-reflow group compared with the normal-reflow group. In the multivariable analysis, %NC volume was the only independent predictor of no-reflow (odds ratio = 1.126; 95% CI 1.045–1.214, P = 0.002). CONCLUSION: In ACS patients, post-stenting no-reflow is associated with plaque components defined by VH-IVUS analysis with larger NC and more TCFAs. Oxford University Press 2011-08 2009-02-19 /pmc/articles/PMC3155758/ /pubmed/19228713 http://dx.doi.org/10.1093/eurheartj/ehp034 Text en Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org. http://creativecommons.org/licenses/by-nc/2.5/ The online version of this article has been published under an open access model. Users are entitled to use, reproduce, disseminate, or display the open access version of this article for non-commercial purposes provided that the original authorship is properly and fully attributed; the Journal, Learned Society and Oxford University Press are attributed as the original place of publication with correct citation details given; if an article is subsequently reproduced or disseminated not in its entirety but only in part or as a derivative work this must be clearly indicated. For commercial re-use, please contact journals.permissions@oxfordjournals.org.
spellingShingle Clinical Research
Hong, Young Joon
Jeong, Myung Ho
Choi, Yun Ha
Ko, Jum Suk
Lee, Min Goo
Kang, Won Yu
Lee, Shin Eun
Kim, Soo Hyun
Park, Keun Ho
Sim, Doo Sun
Yoon, Nam Sik
Youn, Hyun Ju
Kim, Kye Hun
Park, Hyung Wook
Kim, Ju Han
Ahn, Youngkeun
Cho, Jeong Gwan
Park, Jong Chun
Kang, Jung Chaee
Impact of plaque components on no-reflow phenomenon after stent deployment in patients with acute coronary syndrome: a virtual histology-intravascular ultrasound analysis
title Impact of plaque components on no-reflow phenomenon after stent deployment in patients with acute coronary syndrome: a virtual histology-intravascular ultrasound analysis
title_full Impact of plaque components on no-reflow phenomenon after stent deployment in patients with acute coronary syndrome: a virtual histology-intravascular ultrasound analysis
title_fullStr Impact of plaque components on no-reflow phenomenon after stent deployment in patients with acute coronary syndrome: a virtual histology-intravascular ultrasound analysis
title_full_unstemmed Impact of plaque components on no-reflow phenomenon after stent deployment in patients with acute coronary syndrome: a virtual histology-intravascular ultrasound analysis
title_short Impact of plaque components on no-reflow phenomenon after stent deployment in patients with acute coronary syndrome: a virtual histology-intravascular ultrasound analysis
title_sort impact of plaque components on no-reflow phenomenon after stent deployment in patients with acute coronary syndrome: a virtual histology-intravascular ultrasound analysis
topic Clinical Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3155758/
https://www.ncbi.nlm.nih.gov/pubmed/19228713
http://dx.doi.org/10.1093/eurheartj/ehp034
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