Details

Autor(en) / Beteiligte

• Ino, Yasushi
• Takahata, Masahiro
• Kubo, Takashi
• Khalifa, Amir Kh. M.
• Satogami, Keisuke
• Terada, Kosei
• Ozaki, Yuichi
• Katayama, Yosuke
• Taruya, Akira
• Ota, Shingo
• Wada, Teruaki
• Tanimoto, Takashi
• Shiono, Yasutsugu
• Kashiwagi, Manabu
• Kuroi, Akio
• Tanaka, Atsushi

Titel

Vascular Response After Everolimus-Eluting Stent in Acute Myocardial Infarction Caused by Calcified Nodule

Ist Teil von

• Circulation Journal, 2022/08/25, Vol.86(9), pp.1388-1396

Ort / Verlag

Japan: The Japanese Circulation Society

Erscheinungsjahr

2022

Quelle

MEDLINE

Beschreibungen/Notizen

• Background: Patients with acute myocardial infarction (AMI) caused by calcified nodules (CN) have worse clinical outcomes following primary percutaneous coronary intervention (PCI). This study investigated the late vascular response after everolimus-eluting stent (EES) implantation assessed by optical coherence tomography (OCT) in patients with AMI caused by CN, by comparing with plaque rupture (PR) and plaque erosion (PE).Methods and Results: Based on the OCT findings in AMI culprit lesions before PCI, a total of 141 patients were categorized into 3 groups (PR, PE, or CN), and the OCT findings immediately and 10 months after PCI were compared. The frequency of PR, PE, and CN was 85 (60%), 45 (32%), and 11 patients (8%), respectively. In the 10-month follow-up OCT, the frequency of lesions with uncovered struts and lesions with malapposed struts were highest in the CN group, followed by the PR and PE groups (82% vs. 52% vs. 40%, P=0.042 and 73% vs. 26% vs. 16%, P<0.001, respectively). The incidence of intra-stent thrombus, re-appearance of CN within the stent, and target lesion revascularization were higher in the CN group compared with the PR and PE groups (36% vs. 9% vs. 7%, P=0.028; 27% vs. 0% vs. 0%, P<0.001; and 18% vs. 2% vs. 2%, P=0.024, respectively).Conclusions: Late arterial healing response at 10 months after EES implantation in the CN was worse compared with PR and PE in patients with AMI.