Author + information
- Tsuyoshi Osue,
- Toshiro Shinke,
- Hiromasa Otake,
- Masayuki Nakagawa,
- Hirotoshi Hariki,
- Takumi Inoue,
- Yu Taniguchi,
- Masamichi Iwasaki,
- Akihide Konishi,
- Hiroto Kinutani,
- Ryo Nishio,
- Masaru Kuroda and
- Ken–Ichi Hirata
The aim of this study is to clarify the morphological characteristics of lesions prone to micro–vascular dysfunction after PCI.
A total of 59 culprit lesions from 56 patients with stable angina were examined by OCT before PCI to assess the vulnerable findings of the plaque. Subsequently, the index of microcirculatory resistance (IMR) and troponin I was measured before and after PCI. ΔIMR was calculated as Post–IMR minus Pre–IMR.
Among a total of 59 culprit lesions, univariate analysis revealed that MC: micro–channel, thin–cap fibro–atheroma: TCFA, macrophage images: Mϕ was associated with increased ΔIMR (table). When categorized into 3 groups according to these vulnerable characteristics (M–C, TCFA and Mϕ); group 1: without any vulnerable characteristics, group 2: non–TCFA with Mϕ or M–C, group 3: TCFA with Mϕ or M–C, a significant difference was found in ΔIMR among the three groups (−7.02, 9.56, and 13.87 respectively; P=0.001). Finally, there was a stepwise association between numbers of vulnerable characteristics and Δtroponin I level (0.93ng/ml, 1.46ng/ml, 1.84ng/ml respectively; P=0.07).
Baseline plaque vulnerability detected by OCT may be associated with the extent of subsequent micro–vascular dysfunction after PCI.
univariate analysis for ΔIMR
|Macrophage||1.04||0.002||1.04 to 1.18|
|TCFA||1.04||0.02||1.00 to 1.08|
|Micro Channel||1.04||0.03||1.00 to 1.08|
|Cholesterol Crystal||1.04||0.09||1.00 to 1.18|
|Calcification||0.99||0.82||0.97 to 1.03|
|Raptured Plaque||0.97||0.09||0.93 to 1.01|
|Laceration||0.97||0.1||0.93 to 1.01|
|Lipid Pool||1.03||0.09||0.93 to 1.06|
|Thrombus||1.04||0.11||0.99 to 1.10|
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.–10:30 a.m.
Session Title: Intravascular Imaging: IVUS and OCT
Abstract Category: 38. TCT@ACC–i2: Intravascular Imaging and Physiology
Presentation Number: 2108–245
- 2013 American College of Cardiology Foundation