Author + information
- Takayuki Niida,
- Taishi Yonetsu,
- Tadashi Murai,
- Yoshihisa Kanaji,
- Eisuke Usui,
- Masahiro Hoshino,
- Masao Yamaguchi,
- Masahiro Hada,
- Sadamitsu Ichijo,
- Rikuta Hamaya,
- Yoshinori Kanno and
- Tsunekazu Kakuta
Background: Although multiple imaging modalities have been tested to predict periprocedural myocardial necrosis (PMN), superior predictive efficacy of one modality to others has not been fully elucidated. We sought to evaluate which of the coronary imaging tools would provide best predictive efficacy of PMN among optical coherence tomography (OCT), intravascular ultrasound (IVUS), and coronary computed-tomography angiography (CCT).
Methods: A total of 142 patients with stable angina pectoris who underwent preprocedural OCT, IVUS, and CCT were investigated. PMN was defined by two thresholds; moderate PMN as showing post-PCI peak hs-cTnI levels above 20 times of the upper reference limit (URL) and major PMN defined as peak hs-cTnI >70 times of URL. In IVUS analysis, the presence and the length of the echo-attenuated plaque was evaluated. By CCT, the presence of low density plaque defined as a plaque with <30 Hounsfield unit was studied. OCT analysis included the presence or absence of thin cap fibroatheroma and the thinnest fibrous cap thickness.
Results: Moderate PMN was observed in 31 patients (21.8%) and 8 (5.6%) patients showed major PMN. Multivariate logistic regression analysis identified three independent predictors; IVUS-derived echo-attenuated plaque length [OR 1.39 (95%CI 1.16-1.67), p<0.001], OCT-thin cap fibroatheroma [OR 5.0 (95%CI 1.60-15.71), P=0.006], and CCT-low density plaque [OR 1.39 (95%CI 1.16-1.67), p<0.001) for moderate PMN. For the prediction of major PMI, echo-attenuated plaque length was the only independent predictor [OR 1.34 (95%CI 1.09-1.65), P=0.006].
Conclusions: Our study indicated that IVUS-derived echo-attenuated plaque length was the only significant predictor of major PMN, while three modalities provided independently significant predictive efficacy for moderate PMN.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Unusual Presentations of ACS
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1297-349
- 2017 American College of Cardiology Foundation