This study aimed to examine the anti-demineralization capacities of (a) tetracalcium phosphate (TTCP) and dicalcium phosphate anhydrous (DCPA) and 950 ppm fluoride paste, (b) casein phosphopeptide amorphous calcium phosphate paste and (c) 950 ppm fluoride solution using optical coherence tomography (OCT). Enamel blocks were cut from the bovine incisors and treated using one of the above-mentioned three materials or deionized water as control (n=10). All samples were subjected to a demineralization gel for 1 h followed by a remineralization solution for 23 h. This experimental cycle was repeated for 28 days. The specimens were imaged using OCT at baseline and at four stages and measured lesion depth using image analysis software (ImageJ). Repeated measures ANOVA revealed that demineralization time, material and their interaction significantly affected the optical lesion depth (p<0.001). TTCP and DCPA and 950 ppm fluoride paste and 950 ppm fluoride solution showed significantly lower lesion progress compare to other groups (p<0.05).
Introduction:
Optimal revascularization strategy and shorter duration of dual antiplatelet are required in patients with coronary artery disease concomitant with high bleeding risk (HBR). More complex percutaneous coronary intervention (PCI) and subsequent high thrombotic risk in patients with HBR have been also demonstrated. However, the characteristics of culprit plaque in patients with HBR remains to be elucidated.
Hypothesis:
HBR is associated with more complex plaque in culprit lesion in patients requiring PCI.
Methods:
A total of 362 consecutive patients with stable coronary disease, who underwent optical coherence tomography (OCT) imaging of the culprit lesion during PCI were included. The characteristics of culprit plaque assessed by OCT were compared between the HBR group (n=196) and the non-HBR group (n=166), which were classified based on the Academic Research Consortium for High Bleeding Risk (ARC-HBR).
Results:
The prevalence of severe calcified plaque (angle >180 degee, thickness >0.5mm and length >5mm) was significantly higher in the higher HBR group than in the non-HBR group (48 vs. 35%,
p
=0.016), although other characteristics were comparable (Panel A). Among patients with HBR, the incremental prevalence of severe calcified plaque according to the number of major ARC-HBR criteria met was observed (
p
<0.001) (Panel B).
Conclusions:
HBR was associated with a higher prevalence of severe calcified plaque in culprit lesion in patients with stable coronary disease requiring PCI. The greater number of major ARC-HBR criteria met was associated with a higher prevalence of severe calcified plaque among patients with HBR.
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