The influence of coronary plaque morphology assessed by optical coherence tomography on final microvascular function after stenting in patients with ST-elevation myocardial infarction.

ABSTRACT: OBJECTIVES:The index of microcirculatory resistance (IMR) provides a reproducible assessment of the status of coronary microvasculature in patients with ST-elevation myocardial infarction (STEMI). Frequency-domain optical coherence tomography (FD-OCT) enables detailed assessment of the morphology of coronary plaque.We sought to determine the influence of the initial culprit coronary plaque anatomy within the infarct-related artery on IMR after stenting in STEMI. PATIENTS AND METHODS:In 25 STEMI patients IMR was measured immediately before and after stent implantation. FD-OCT imaging was performed at the same time points and atherothrombotic volume (ATV) before stenting, prolapsed+floating ATV after stenting and ?ATV was measured using three different strategies. RESULTS:There were no relationships between preprocedural IMR and FD-OCT parameters. Prestenting IMR was related only to pain to wire time (P: 0.02). Irrespective of the method adopted, the final IMR was related to prestenting ATV (?: 0.44, P: 0.03 for method I, ?: 0.48, P: 0.02 for method II and ?: 0.30, P: 0.06 for method III) and ?ATV (?: 0.41, P: 0.04 for method II and ?: 0.44, P: 0.03 for method III). CONCLUSION:IMR measured before stenting is independent of the appearances of the culprit coronary plaque within the infarct-related artery. IMR after stenting, and more importantly, the change in IMR after stenting, reflect the degree of distal embolization during stent implantation.

SUBMITTER: De Maria GL 

PROVIDER: S-EPMC5404714 | biostudies-literature | 2017 May

REPOSITORIES: biostudies-literature