- 著者
- Chiara Bernelli Kunihiro Shimamura Kenichi Komukai Davide Capodanno Francesco Saia Roberto Garbo Francesco Burzotta Vasile Sirbu Micol Coccato Gianluca Campo Luigi Vignali Hirosada Yamamoto Giampaolo Niccoli Elena Ladich Giuseppe Biondi-Zoccai Giulio Guagliumi
- 出版者
- 日本循環器学会
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- pp.CJ-15-1140, (Released:2016-02-08)
- 参考文献数
- 23
- 被引用文献数
- 1 5
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 infarct-related 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.
- 著者
- Takashi Yamano Takashi Kubo Yasutsugu Shiono Kunihiro Shimamura Makoto Orii Takashi Tanimoto Yoshiki Matsuo Yasushi Ino Hironori Kitabata Tomoyuki Yamaguchi Kumiko Hirata Atsushi Tanaka Toshio Imanishi Takashi Akasaka
- 出版者
- 一般社団法人 日本動脈硬化学会
- 雑誌
- Journal of Atherosclerosis and Thrombosis (ISSN:13403478)
- 巻号頁・発行日
- pp.25593, (Released:2014-08-15)
- 参考文献数
- 22
- 被引用文献数
- 6 33
Aim: Previous clinical trials have demonstrated the effectiveness of eicosapentaenoic acid (EPA) in preventing cardiovascular events. The aim of the present study was to investigate the effects of EPA treatment on the accumulation of coronary atherosclerotic plaque using optical coherence tomography (OCT). Methods: A total of 46 acute coronary syndrome (ACS) patients without dyslipidemia were divided into two groups: those who received 1,800 mg/day of EPA (n=15) or the control group (n=31). Serial OCT examinations were performed at baseline and after eight months of follow-up. The target for the OCT analysis was non-culprit plaque with a percent diameter of stenosis of 30% to 70% in non-culprit vessels of ACS. Results: Between the baseline and follow-up visits, the serum EPA levels increased (50±26 mg/dL to 200±41 mg/dL, p<0.001) in the EPA group, although they did not change in the control group. According to the OCT analysis, the lipid arc did not change in the EPA group (131±52 degrees to 126±54 degrees, p=0.106) or the control group (137±50 degrees to 138±50 degrees, p=0.603). In contrast, the fibrous cap thickness significantly increased in both the EPA group (169±70 μm to 201±49 μm, p<0.001) and the control group (164±63 μm to 174±72 μm, p=0.018); however, the relative change in the fibrous cap thickness was significantly greater in the EPA group than in the control group (131±35% vs. 106±15%, p=0.001). Conclusions: In the present study, the administration of EPA for eight months significantly increased the fibrous cap thickness in patients with coronary atherosclerotic plaque.