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Association Between Preinfarction Angina and Culprit Lesion Morphology in Patients With ST-Segment Elevation Myocardial Infarction: An Optical Coherence Tomography Study
BACKGROUND: Previous studies reported the cardiac protection effect of preinfarction angina (PIA) in patients with acute myocardial infarction (AMI). We sought to identify culprit-plaque morphology and clinical outcomes associated with PIA in patients with ST-segment elevation myocardial infarction...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8804379/ https://www.ncbi.nlm.nih.gov/pubmed/35118138 http://dx.doi.org/10.3389/fcvm.2021.678822 |
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author | Wang, Ying Sheng, Zhaoxue Li, Jiannan Tan, Yu Zhou, Peng Liu, Chen Zhao, Xiaoxiao Zhou, Jinying Chen, Runzhen Song, Li Zhao, Hanjun Yan, Hongbing |
author_facet | Wang, Ying Sheng, Zhaoxue Li, Jiannan Tan, Yu Zhou, Peng Liu, Chen Zhao, Xiaoxiao Zhou, Jinying Chen, Runzhen Song, Li Zhao, Hanjun Yan, Hongbing |
author_sort | Wang, Ying |
collection | PubMed |
description | BACKGROUND: Previous studies reported the cardiac protection effect of preinfarction angina (PIA) in patients with acute myocardial infarction (AMI). We sought to identify culprit-plaque morphology and clinical outcomes associated with PIA in patients with ST-segment elevation myocardial infarction (STEMI) using optical coherence tomography (OCT). METHODS AND RESULTS: A total of 279 patients with STEMI between March 2017 and March 2019 who underwent intravascular OCT of the culprit lesion were prospectively included. Of them, 153 (54.8%) patients were presented with PIA. No differences were observed in clinical and angiographic data between the two groups, except STEMI onset with exertion was significantly less common in the PIA group (24.2 vs. 40.5%, p = 0.004). Patients with PIA exhibited a significantly lower incidence of plaque rupture (40.5 vs. 61.9%, p < 0.001) and lipid-rich plaques (48.4 vs. 69.0%, p = 0.001). The thin-cap fibroatheroma (TCFA) prevalence was lower in the PIA group, presenting a thicker fibrous cap thickness, although statistically significant differences were not observed (20.3 vs. 30.2%, p = 0.070; 129.1 ± 92.0 vs. 111.4 ± 78.1 μm, p = 0.088; respectively). The multivariate logistic regression analysis indicated that PIA was an independent negative predictor of plaque rupture (odds ratio: 0.44, 95% CI: 0.268–0.725, p = 0.001). No significant differences in clinical outcomes were observed besides unplanned revascularization. CONCLUSION: Compared with the non-PIA group, STEMI patients with PIA showed a significantly lower prevalence of plaque rupture and lipid-rich plaques in culprit lesion, implying different mechanisms of STEMI attack in these two groups. |
format | Online Article Text |
id | pubmed-8804379 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-88043792022-02-02 Association Between Preinfarction Angina and Culprit Lesion Morphology in Patients With ST-Segment Elevation Myocardial Infarction: An Optical Coherence Tomography Study Wang, Ying Sheng, Zhaoxue Li, Jiannan Tan, Yu Zhou, Peng Liu, Chen Zhao, Xiaoxiao Zhou, Jinying Chen, Runzhen Song, Li Zhao, Hanjun Yan, Hongbing Front Cardiovasc Med Cardiovascular Medicine BACKGROUND: Previous studies reported the cardiac protection effect of preinfarction angina (PIA) in patients with acute myocardial infarction (AMI). We sought to identify culprit-plaque morphology and clinical outcomes associated with PIA in patients with ST-segment elevation myocardial infarction (STEMI) using optical coherence tomography (OCT). METHODS AND RESULTS: A total of 279 patients with STEMI between March 2017 and March 2019 who underwent intravascular OCT of the culprit lesion were prospectively included. Of them, 153 (54.8%) patients were presented with PIA. No differences were observed in clinical and angiographic data between the two groups, except STEMI onset with exertion was significantly less common in the PIA group (24.2 vs. 40.5%, p = 0.004). Patients with PIA exhibited a significantly lower incidence of plaque rupture (40.5 vs. 61.9%, p < 0.001) and lipid-rich plaques (48.4 vs. 69.0%, p = 0.001). The thin-cap fibroatheroma (TCFA) prevalence was lower in the PIA group, presenting a thicker fibrous cap thickness, although statistically significant differences were not observed (20.3 vs. 30.2%, p = 0.070; 129.1 ± 92.0 vs. 111.4 ± 78.1 μm, p = 0.088; respectively). The multivariate logistic regression analysis indicated that PIA was an independent negative predictor of plaque rupture (odds ratio: 0.44, 95% CI: 0.268–0.725, p = 0.001). No significant differences in clinical outcomes were observed besides unplanned revascularization. CONCLUSION: Compared with the non-PIA group, STEMI patients with PIA showed a significantly lower prevalence of plaque rupture and lipid-rich plaques in culprit lesion, implying different mechanisms of STEMI attack in these two groups. Frontiers Media S.A. 2022-01-18 /pmc/articles/PMC8804379/ /pubmed/35118138 http://dx.doi.org/10.3389/fcvm.2021.678822 Text en Copyright © 2022 Wang, Sheng, Li, Tan, Zhou, Liu, Zhao, Zhou, Chen, Song, Zhao and Yan. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Cardiovascular Medicine Wang, Ying Sheng, Zhaoxue Li, Jiannan Tan, Yu Zhou, Peng Liu, Chen Zhao, Xiaoxiao Zhou, Jinying Chen, Runzhen Song, Li Zhao, Hanjun Yan, Hongbing Association Between Preinfarction Angina and Culprit Lesion Morphology in Patients With ST-Segment Elevation Myocardial Infarction: An Optical Coherence Tomography Study |
title | Association Between Preinfarction Angina and Culprit Lesion Morphology in Patients With ST-Segment Elevation Myocardial Infarction: An Optical Coherence Tomography Study |
title_full | Association Between Preinfarction Angina and Culprit Lesion Morphology in Patients With ST-Segment Elevation Myocardial Infarction: An Optical Coherence Tomography Study |
title_fullStr | Association Between Preinfarction Angina and Culprit Lesion Morphology in Patients With ST-Segment Elevation Myocardial Infarction: An Optical Coherence Tomography Study |
title_full_unstemmed | Association Between Preinfarction Angina and Culprit Lesion Morphology in Patients With ST-Segment Elevation Myocardial Infarction: An Optical Coherence Tomography Study |
title_short | Association Between Preinfarction Angina and Culprit Lesion Morphology in Patients With ST-Segment Elevation Myocardial Infarction: An Optical Coherence Tomography Study |
title_sort | association between preinfarction angina and culprit lesion morphology in patients with st-segment elevation myocardial infarction: an optical coherence tomography study |
topic | Cardiovascular Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8804379/ https://www.ncbi.nlm.nih.gov/pubmed/35118138 http://dx.doi.org/10.3389/fcvm.2021.678822 |
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