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 –
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- Bernelli Chiara
- Interventional Cardiology Unit, Azienda Ospedaliera Papa Giovanni XXIII
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- Shimamura Kunihiro
- Interventional Cardiology Unit, Azienda Ospedaliera Papa Giovanni XXIII
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- Komukai Kenichi
- Interventional Cardiology Unit, Azienda Ospedaliera Papa Giovanni XXIII
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- Capodanno Davide
- Ferrarotto Hospital, University of Catania
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- Saia Francesco
- Institute of Cardiology, University of Bologna, Policlinico S. Orsola-Malpighi
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- Garbo Roberto
- Cardiology Department, Ospedale San Giovanni Bosco
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- Burzotta Francesco
- Cardiology Department, Institute of Cardiology, Catholic University of the Sacred Heart
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- Sirbu Vasile
- Interventional Cardiology Unit, Azienda Ospedaliera Papa Giovanni XXIII
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- Coccato Micol
- Interventional Cardiology Unit, Azienda Ospedaliera Papa Giovanni XXIII
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- Campo Gianluca
- Cardiovascular Institute, Azienda Ospedaliera Universitaria di Ferrara
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- Vignali Luigi
- Cardiology Department, Azienda Ospedaliero Univeristaria di Parma
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- Yamamoto Hirosada
- Case Western Reserve University
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- Niccoli Giampaolo
- Cardiology Department, Ospedale San Giovanni Bosco
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- Ladich Elena
- CV Path Institute
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- Biondi-Zoccai Giuseppe
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome
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- Guagliumi Giulio
- Interventional Cardiology Unit, Azienda Ospedaliera Papa Giovanni XXIII
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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. (Circ J 2016; 80: 895–905)
収録刊行物
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- Circulation Journal
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Circulation Journal 80 (4), 895-905, 2016
一般社団法人 日本循環器学会
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詳細情報 詳細情報について
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- CRID
- 1390282680085753472
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- NII論文ID
- 130005139569
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- NII書誌ID
- AA11591968
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- ISSN
- 13474820
- 13469843
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- NDL書誌ID
- 027203056
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- PubMed
- 26853719
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- 本文言語コード
- en
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- データソース種別
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- JaLC
- NDL
- Crossref
- PubMed
- CiNii Articles
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