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Objectives:To evaluate the angiographic and intravascular ultrasound (IVUS) characteristics of coronary mismatch lesions.Background:Better understanding about the characteristics of mismatch lesions may help to achieve more accurate lesion assessment and, thereby, to improve the outcomes of percutaneous coronary intervention (PCI).Methods:Angiographic and IVUS data from 1369 lesions were analyzed. Mismatch lesion was defined as the difference between proximal and distal reference lumen diameters of ≥1.0 mm or ≥30% of the distal reference lumen diameter.Results:The incidence of mismatch lesions was 20.1% (275/1369). Compared to nonmismatch group, mismatch group had longer lesions (21.3 [6.4] mm vs 18.4 [6.4] mm, P < .001) with smaller minimum lumen diameter (0.87 [0.29] mm vs 1.10 [0.31] mm, P < .001) and more severe diameter stenosis (78.8% [9.2%] vs 66.3% [10.3%], P < .001). On IVUS, mismatch group had larger lumen area (18.7 [5.0] vs 15.8 [5.1] mm2, P < .001) but lower plaque burden at the proximal reference segment (41.0% [9.2%] vs 45.7% [9.9%], P < .001) and smaller lumen area (4.83 [1.89] vs 7.36 [2.89] mm, P < .001) but higher plaque burden at the distal reference segment (42.9% [10.4%] vs 41.4% [10.1%], P = .023). Multivariable logistic regression analysis showed that mismatch lesions were frequently accompanied by diffuse lesions (odds ratio [OR] = 2.50; 95% confidence interval [CI]: 1.83-3.40; P < .001), bifurcation lesions (OR = 5.83; 95% CI: 4.40-7.74; P < .001), and lesions with a low TIMI flow grade (OR = 1.70; 95% CI: 1.08-2.67; P = .022) or severe diameter stenosis (OR = 3.05; 95% CI: 2.10-4.43; P < .001).Conclusions:Mismatch lesions are quite common and characterized by greater lesion complexity compared with nonmismatch lesions. Further studies may be necessary to address the impact of this lesion type on the outcome of PCI.

Aim: The aim of this study was to determine why bystanders did not use formal Emergency Medical Services (EMS) or conduct cardiopulmonary resuscitation (CPR) on the scene for out-of-hospital cardiac arrest (OHCA) patients in Hanoi, Vietnam. Methods: This was a prospective, observational study of OHCA patients admitted to five tertiary hospitals in the Hanoi area from June 2018 through January 2019. The data were collected through interviews (using a structured questionnaire) with bystanders. Results: Of the 101 patients, 79% were aged <65 years, 71% were men, 79% were witnessed to collapse, 36% were transported to the hospital by formal EMS, and 16% received bystander CPR at the scene. The most frequently indicated reason for not using EMS by the attendants was “using a private vehicle or taxi is faster” (85%). The reasons bystanders did not conduct CPR at the scene included “not recognizing the ailment as cardiac arrest” (60%), “not knowing how to perform CPR” (33%), and “being afraid of doing harm to patients” (7%). Only seven percent of the bystanders had been trained in CPR. Conclusion: The information revealed in this study provides useful information to indicate what to do to increase EMS use and CPR provision. Spreading awareness and training among community members regarding EMS roles, recognition of cardiac arrest, CPR skills, and dispatcher training to assist bystanders are crucial to improve the outcomes of OHCA patients in Vietnam.