Impact of culprit plaque and atherothrombotic components on incomplete stent apposition in patients with ST-elevation myocardial infarction treated with Everolimus-eluting stents-an OCTAVIA Substudy

Francesco Burzotta, Gabriella Campoli, Giampaolo Niccoli, Chiara Bernelli, Kunihiro Shimamura, Kenichi Komukai, Davide Capodanno, Francesco Saia, Roberto Garbo, Vasile Sirbu, Micol Coccato, Gianluca Campo, Luigi Vignali, Hirosada Yamamoto, Elena Ladich, Giulio Guagliumi

Risultato della ricerca: Contributo in rivistaArticolo in rivista

4 Citazioni (Scopus)

Abstract

Background: The role of culprit plaque and related atherothrombotic components on incomplete stent apposition (ISA) occurrence after primary percutaneous coronary intervention (p-PCI) is unknown. Methods and Results: ST-segment elevation myocardial infarction (STEMI) patients undergoing p-PCI with an everolimus-eluting stent were prospectively investigated with optical coherence tomography (OCT) of the infarctrelated artery before, after stenting and at 9 months. OCT data, aspirated thrombus and serum inflammatory biomarkers were analyzed. 114 patients with 114 lesions were evaluated. Acute ISA occurred in 82 lesions (71.9%), preferentially in larger vessels with a median area of 0.2 mm2. The presence of thrombus before stent implantation (odds ratio (OR) 5.5, 95% confidence interval (CI) [1.1–26.9], P=0.04) and the lipid content in the target segment (OR 1.3, 95% CI [1.0–1.5], P=0.04) independently predicted acute ISA. At 9-month follow-up, ISA persisted in 46 lesions (56.1%). The volume of acute ISA significantly predicted persistent ISA (OR 1.3, 95% CI [1.1–1.5], P=0.01). Late-acquired ISA occurred in 39 lesions (34.2%) with a median area of 0.3 mm2. Red/mixed thrombus before stent implantation (OR 3.7, 95% CI [1.0–13.3], P=0.05) and length of the underlying ruptured plaque (OR 1.7, 95% CI [1.1–2.8] P=0.02) were independently associated with late-acquired ISA. Conclusions: In STEMI patients, culprit plaque and atherothrombotic components of the infarct-related artery significantly contribute to the onset of acute and late ISA. ISA persistence at follow-up depends on the initial volume of acute ISA.
Lingua originaleEnglish
pagine (da-a)895-905
Numero di pagine11
RivistaCirculation Journal
Volume80
DOI
Stato di pubblicazionePubblicato - 2016

Keywords

  • Acute myocardial infarction
  • Aged
  • Drug-Eluting Stents
  • Drug-eluting stent
  • Everolimus
  • Everolimus-eluting stent
  • Female
  • Humans
  • Incomplete stent apposition
  • Male
  • Middle Aged
  • Myocardial Infarction
  • Optical coherence tomography
  • Percutaneous Coronary Intervention
  • Plaque, Atherosclerotic
  • Thrombosis

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