Atherosclerotic Plaque With Ultrasonic Attenuation Affects Coronary Reflow and Infarct Size in Patients With Acute Coronary Syndrome : An Intravascular Ultrasound Study
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概要
- 論文の詳細を見る
Background No reflow following percutaneous coronary intervention (PCI) is a major concern in patients with acute coronary syndrome (ACS) and it may be influenced by the preexisting plaque type. Methods and Results To evaluate the impact of plaque characteristics on coronary reflow following PCI in patients with ACS, a total of 110 patients (89 acute myocardial infarction, 21 unstable angina) were assessed by intravascular ultrasound. Plaque type was categorized as either atherosclerotic plaque without ultrasonic attenuation (group 1) or atherosclerotic plaque with attenuation (group 2). External elastic membrane, plaque plus media, and lumen area were measured. Coronary flow was assessed by Thrombolysis in Myocardial Infarction (TIMI) grade and TIMI frame count. Although the final TIMI frame count was similar between the 2 groups, TIMI frame count immediately after the first balloon inflation was significantly higher in group2 (p=0.03). Despite the similar final TIMI grade and TIMI frame count, peak creatine kinase level was significantly higher (3,035±2,553 vs 1,950±1,958IU/L, p=0.04) and fatal arrhythmia more frequently observed (16.4% vs 2.7%, p=0.04) in group 2 than in group 1. Conclusions Atherosclerotic plaque with ultrasonic attenuation may be related to a transient deterioration in coronary flow and as a result larger infarct size and higher incidence of fatal arrhythmia following PCI in patients with ACS. These results may help in selecting lesions suitable for distal protection devices.
- 社団法人日本循環器学会の論文
- 2007-04-20
著者
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YOSHIYAMA Minoru
Departments of Internal Medicine and Cardiology, Osaka City University Graduate School of Medicine
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Yoshida Kaoru
Department Of Cardiology Kawasaki Medical School
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Yoshikawa Junichi
Department of Internal Medicine and Cardiology, Osaka City University School of Medicine
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Yoshikawa J
Department Of Medicine Cardiovascular Division Osaka Ekisaikai Hospital
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Yoshiyama M
Department Of Internal Medicine And Cardiology Osaka City University Medical School
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Yamaguchi Junichi
Division Of Cardiology Saitama Prefecture Cardiovascular And Respiratory Center
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Taguchi Haruyuki
Department Of Medicine Cardiovascular Division Osaka Ekisaikai Hospital
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Yoshikawa Junichi
大阪掖済会病院 循環器科
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Taguchi Haruyuki
Osaka Ekisaikai Hospital
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Taguchi Haruyuki
Division Of Cardiology Bell Land General Hospital
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Yoshiyama Minoru
Department Of Internal Medicine And Cardiology Graduate School Of Medicine Osaka City University
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OKURA Hiroyuki
Division of Cardiology, Kawasaki Medical School
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YOSHIDA Kiyoshi
Division of Cardiology, Kawasaki Medical School
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Yamaguchi Junichi
Kanto Medical Center NTT-EC
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Kubo Tomoichiro
Division of Cardiology, Bell Land General Hospital
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Toda Iku
Division of Cardiology, Bell Land General Hospital
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Toda Iku
Division Of Cardiology Bell Land General Hospital
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Okura Hiroyuki
Department Of Cardiology Kawasaki Medical School
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Okura Hiroyuki
Division Of Cardiology Kawasaki Medical School
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Kubo Tomoichiro
Bell land general hospital
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Taguchi Haruyuki
Department Of Internal Medicine And Cardiology Osaka Ekisaikai Hospital
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Yoshida Kiyoshi
Division Of Cardiology Kawasaki Medical School
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Yoshikawa Junichi
Department Of Cardiology Osaka City University Medical School
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Yamaguchi Junichi
NTT East Japan Kanto Hospital
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Yoshida Kentaro
Department Of Cardiology Institute Of Clinical Medicine University Of Tsukuba
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Okura Hiroyuki
Division Of Cardiology Bell Land General Hospital
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Yoshikawa Junichi
Department Of Cardiovascular Medicine Osaka City University Graduated School Of Medicine
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Yoshiyama Minoru
Department Of Cardiology And Internal Medicine Medical School Osaka City University
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Yoshioka Kunihiro
Actmce1 Trial Investigators
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YOSHIYAMA Minoru
Department Internal Medicine and Cardiology, Osaka City University School of Medicine
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