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Three-dimensional assessment of coronary high-intensity plaques with T1-weighted cardiovascular magnetic resonance imaging to predict periprocedural myocardial injury after elective percutaneous coronary intervention.

ABSTRACT: BACKGROUND:Periprocedural myocardial injury (pMI) is a common complication of elective percutaneous coronary intervention (PCI) that reduces some of the beneficial effects of coronary revascularization and impacts the risk of cardiovascular events. We developed a 3-dimensional volumetric cardiovascular magnetic resonance (CMR) method to evaluate coronary high intensity plaques and investigated their association with pMI after elective PCI. METHODS:Between October 2012 and October 2016, 141 patients with stable coronary artery disease underwent T1-weighted CMR imaging before PCI. A conventional 2-dimensional CMR plaque-to-myocardial signal intensity ratio (2D-PMR) and the newly developed 3-dimensional integral of PMR (3Di-PMR) were measured. 3Di-PMR was determined as the sum of PMRs above a threshold of >?1.0 for voxels in a target plaque. pMI was defined as high-sensitivity cardiac troponin T?>?0.07?ng/mL. RESULTS:pMI following PCI was observed in 46 patients (33%). 3Di-PMR was significantly higher in patients with pMI than those without pMI. The optimal 3Di-PMR cutoff value for predicting pMI was 51 PMR*mm3 and the area under the receiver operating characteristic curve (0.753) was significantly greater than that for 2D-PMR (0.683, P =?0.015). 3Di-PMR was positively correlated with lipid volume (r?=?0.449, P

SUBMITTER: Hosoda H

PROVIDER: S-EPMC6964021 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Three-dimensional assessment of coronary high-intensity plaques with T1-weighted cardiovascular magnetic resonance imaging to predict periprocedural myocardial injury after elective percutaneous coronary intervention.

Hosoda Hayato H Asaumi Yasuhide Y Noguchi Teruo T Morita Yoshiaki Y Kataoka Yu Y Otsuka Fumiyuki F Nakao Kazuhiro K Fujino Masashi M Nagai Toshiyuki T Nakai Michikazu M Nishimura Kunihiro K Kono Atsushi A Komori Yoshiaki Y Hoshi Tomoya T Sato Akira A Kawasaki Tomohiro T Izumi Chisato C Kusano Kengo K Fukuda Tetsuya T Yasuda Satoshi S

Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance 20200116 1

<h4>Background</h4>Periprocedural myocardial injury (pMI) is a common complication of elective percutaneous coronary intervention (PCI) that reduces some of the beneficial effects of coronary revascularization and impacts the risk of cardiovascular events. We developed a 3-dimensional volumetric cardiovascular magnetic resonance (CMR) method to evaluate coronary high intensity plaques and investigated their association with pMI after elective PCI.<h4>Methods</h4>Between October 2012 and October ...[more]

PMID: 31941517

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Project description:BackgroundEvidence suggests that high-dose statin pretreatment may reduce the risk of periprocedural myocardial infarction (PMI) and major adverse cardiac events (MACE) for certain patients; however, previous analyses have not considered patients with a history of statin maintenance treatment. In this meta-analysis of randomized controlled trials (RCTs), we reevaluated the efficacy of short-term high-dose statin pretreatment to prevent PMI and MACE in an expanded set of patients undergoing elective percutaneous coronary intervention.MethodsWe searched the PubMed/Medline database for RCTs that compared high-dose statin pretreatment with no statin or low-dose statin pretreatment as a prevention of PMI and MACE. We evaluated the incidence of PMI and MACE, including death, spontaneous myocardial infarction, and target vessel revascularization at the longest follow-up for each study for subgroups stratified by disease classification and prior low-dose statin treatment.ResultsTwenty-four RCTs with a total of 5,526 patients were identified. High-dose statin pretreatment was associated with 59% relative reduction in PMI (odds ratio [OR]: 0.41; 95% confidence interval [CI]: 0.34-0.49; P<0.00001) and 39% relative reduction in MACE (OR: 0.61; 95% CI: 0.45-0.83; P = 0.002). The benefit of high-dose statin pretreatment on MACE was significant for statin-naive patients (OR: 0.69; 95% CI: 0.50-0.95; P = 0.02) and prior low dose statin-treated patients (OR: 0.28; 95% CI: 0.12-0.65; P = 0.003); and for patients with acute coronary syndrome (OR: 0.52; 95% CI: 0.34-0.79; P = 0.003), but not for patients with stable angina (OR: 0.71; 95% CI 0.45-1.10; P = 0.12). Long-term effects on survival were less obvious.ConclusionsHigh-dose statin pretreatment can result in a significant reduction in PMI and MACE for patients undergoing elective PCI. The positive effect of high-dose statin pretreatment on PMI and MACE is significant for statin-naïve patients and patients with prior treatment. The positive effect of high-dose statin pretreatment on MACE is significant for patients with acute coronary syndrome.

Dataset Information

Three-dimensional assessment of coronary high-intensity plaques with T1-weighted cardiovascular magnetic resonance imaging to predict periprocedural myocardial injury after elective percutaneous coronary intervention.

Publications

Three-dimensional assessment of coronary high-intensity plaques with T1-weighted cardiovascular magnetic resonance imaging to predict periprocedural myocardial injury after elective percutaneous coronary intervention.

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