The Impact of Plaque Characterization Assessed by Intravascular Ultrasound on Myocardial Perfusion After Primary Angioplasty in Patients With ST-Segment Elevation Myocardial Infarction
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概要
- 論文の詳細を見る
Background: Previous studies described that inadequate tissue perfusion after primary angioplasty in ST-elevation myocardial infarction (STEMI) patients is associated with adverse cardiac events. This study evaluated whether plaque morphological intravascular ultrasound (IVUS) characteristics affects tissue perfusion after stent implantation in STEMI patients. Methods and Results: A total of consecutive 306 STEMI patients who underwent primary angioplasty with IVUS were analyzed. Maximum ST-segment elevation before angioplasty was compared with ST-segment levels 60min after angioplasty. Percent ST-segment resolution (STR) was calculated and categorized as complete (>70%), partial (30-70%), and absent (<30%). Qualitative and quantitative IVUS analyses were performed using standard methods. Plaque with ultrasound attenuation was defined as IVUS finding with backward signal attenuation behind plaque >180° without dense calcium. One-hundred-fifty patients had complete, 101 had partial, and 55 had absent STR. The incidence of in-hospital death tended to be higher in absent STR than in partial and complete STR groups. Multivariate analysis indicated that remodeling index (P=0.004), the presence of ultrasound attenuation (P=0.02), percentage stent expansion (P=0.03), and the presence of deep calcium (P=0.049) were the independent predictors related to the occurrence of absent STR after angioplasty. Conclusions: Positive vessel remodeling, plaque with ultrasound attenuation >180°, deep calcium, and stent overexpansion as assessed by IVUS are associated with the absence of STR after primary angioplasty in patients with STEMI. (Circ J 2011; 75: 2642-2647)
- 社団法人 日本循環器学会の論文
- 2011-10-25
著者
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Masutani Motomaru
Division of Cardiolgy, Hyogo College of Medicine
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Fujii Kenichi
Division Of Coronaty Heart Disease Department Of Internal Medicine Hyogo College Of Medicine
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Masuyama Tohru
Cardiovascular Division Department Of Internal Medicine Hyogo College Of Medicine
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Matsumoto Mika
Cardiovascular Division Department Of Internal Medicine Hyogo College Of Medicine
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Ohyanagi M
Division Of Coronary Heart Disease Department Of Internal Medicine Hyogo College Of Medicine
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Kawasaki Daizo
Department Of Internal Medicine Cardiology Division Hyogo College Of Medicine
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Kawasaki Daizo
Department Of Internal Medicine Cardiovascular Division Hyogo College Of Medicine
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Nakata Tsuyoshi
Cardiovascular Center Kawachi General Hospital
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MORITA MASATO
The First department Department of Medicine
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Ohyanagi Mitsumasa
Division Of Coronary Heart Disease Hyogo College Of Medicine
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Ohyanagi Mitsumasa
Department Of Internal Medicine Cardiovascular Division Hyogo College Of Medicine
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Masutani Motomaru
First Department Of Internal Medicine Hyogo College Of Medicine
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Kawasaki Daizo
Cardiovascular Division Department Of Internal Medicine Hyogo College Of Medicine
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Ohyanagi Mitsumasa
Division Of Coronary Heart Disease Department Of Internal Medicine Hyogo College Of Medicine
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Naka Toshio
Department Of Internal Medicine Division Of Coronary Heart Disease Hyogo College Of Medicine
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Masutani Motomaru
Cardiovascular Division Department Of Internal Medicine Hyogo College Of Medicine
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Masai Miho
Division Of Coronary Heart Disease Department Of Internal Medicine Hyogo College Of Medicine
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FUKUNAGA Masashi
Cardiovascular Division, Department of Internal Medicine, Hyogo College of Medicine
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Fujii Kenichi
Cardiovascular Division Department Of Internal Medicine Hyogo College Of Medicine
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Ohyanagi Mitsumasa
The 1st Department Of Internal Medicine Hyogo College Of Medicine
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Oyanagi Mitumasa
Dept. Of 1st Internal Medicine Hyogo College Of Medicine.
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Fukunaga Masashi
Cardiovascular Division Department Of Internal Medicine Hyogo College Of Medicine
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KAWABATA LEE
Cardiovascular Division, Hyogo College of Medicine
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Kawabata Lee
Cardiovascular Division Hyogo College Of Medicine
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Ohyanagi Mitsumasa
Department Of Cardiology Takarazuka Municipal Hospital
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Nakata Tsuyoshi
Cardiovascular Division Hyogo College Of Medicine
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