Assessment of Residual Vasospasm in Patients with Plaque Rupture or Plaque Erosion using Optical Coherence Tomography
-
- Sekimoto Teruo
- Division of Cardiology, Department of Medicine, Showa University School of Medicine Division of Cardiology, Department of Medicine, Showa University Fujigaoka Hospital
-
- Mori Hiroyoshi
- Division of Cardiology, Department of Medicine, Showa University Fujigaoka Hospital
-
- Koba Shinji
- Division of Cardiology, Department of Medicine, Showa University School of Medicine Division of General Medicine, Department of Perioperative Medicine, Showa University School of Dentistry
-
- Arai Taito
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
-
- Matsukawa Naoki
- Department of Legal Medicine, Showa University School of Medicine
-
- Sakai Rikuo
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
-
- Yokota Yuya
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
-
- Sato Shunya
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
-
- Tanaka Hideaki
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
-
- Masaki Ryota
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
-
- Oishi Yosuke
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
-
- Ogura Kunihiro
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
-
- Arai Ken
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
-
- Nomura Kosuke
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
-
- Sakai Koshiro
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
-
- Tsujita Hiroaki
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
-
- Kondo Seita
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
-
- Tsukamoto Shigeto
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
-
- Suzuki Hiroshi
- Division of Cardiology, Department of Medicine, Showa University Fujigaoka Hospital
-
- Shinke Toshiro
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
抄録
<p> Aims: Coronary vasospasm is associated with acute coronary syndrome (ACS) and may persist during primary percutaneous coronary intervention (PCI). We aimed to elucidate the incidence, morphological characteristics, and prognostic impact of residual vasospasm in plaque rupture (PR) and plaque erosion (PE) lesions using optical coherence tomography (OCT).</p><p>Methods: We enrolled 142 patients with ACS who underwent OCT-guided primary PCI. All patients received intracoronary vasodilators before OCT examination. Residual vasospasm was identified as intimal gathering and categorised as polygonal- or wavy- patterned depending on the luminal shape. A wavy pattern was defined as a curved intimal surface line. A polygonal pattern was defined as a lumen with multiple angles. The incidence of major cardiovascular events, defined as death, non-fatal myocardial infarction, stroke, and any revascularization, within 1-year of PCI was identified.</p><p>Results: The prevalence of residual vasospasm in PR and PE was 15.1% (13 of 86) and 21.4% (12 of 56), respectively. Wavy pattern was the major shape of the residual vasospasm. Polygonal-patterned lumen was more frequently observed in PR than in PE (38.5 vs. 8.3 %). The polygonal-patterned lumens had significantly larger lipid arcs (257.9 vs. 78.0 °; P＜0.01), and significantly smaller areas (1.27 vs. 1.88 mm2; P=0.05) than wavy-patterned lumens. Residual vasospasm had a prognostic impact on PR but not PE at 1-year of successful primary PCI.</p><p> Conclusion: Considerable proportion of ACS including both PR and PE had residual vasospasm with variable morphological feature and different prognostic impact.</p>
収録刊行物
-
- Ｊｏｕｒｎａｌ ｏｆ Ａｔｈｅｒｏｓｃｌｅｒｏｓｉｓ ａｎｄ Ｔｈｒｏｍｂｏｓｉｓ
-
Ｊｏｕｒｎａｌ ｏｆ Ａｔｈｅｒｏｓｃｌｅｒｏｓｉｓ ａｎｄ Ｔｈｒｏｍｂｏｓｉｓ 31 (5), 559-571, 2024-05-01
一般社団法人 日本動脈硬化学会