Background
Calcified plaque is thought to adversely impact outcomes after percutaneous coronary intervention (PCI). This study sought to evaluate the impact of nodular calcification in patients with acute coronary syndrome treated with primary percutaneous coronary intervention.
Methods
Using optical coherence tomography (OCT), 500 culprit plaques with calcification were analyzed from 495 acute coronary syndrome (ACS) patients on whom PCI was performed. Based on morphology, we classified calcification into two subtypes: nodular calcification and non-nodular calcification. Nodular calcification was defined as protruding mass with an irregular surface, high backscattering, and signal attenuation while non-nodular calcification was defined as an area with low backscattering heterogeneous region with a well-delineated border without protrusion into the lumen on OCT.
Results
Calcified culprit plaques were divided into nodular calcification group (n = 238) and non-nodular calcification group (n = 262). Patients with nodular calcification were older (p < 0.001) and had lower left ventricular ejection fraction (p = 0.006) compared to patients with non-nodular calcification. Minimum stent area (5.0 (3.9, 6.3) mm2 vs. 5.4 (4.2, 6.7) mm2, p = 0.011) and stent expansion (70 (62.7, 81.8) % vs. 75 (65.2, 86.6) %, p = 0.004) were significantly smaller in the nodular calcification group than in the non-nodular calcification group. Stent under-expansion was most frequent (p = 0.003) in the nodular calcification group.
Conclusion
This study demonstrate that the presence of nodular calcification is associated with a smaller minimum stent area and a higher incidence of stent under-expansion. Lesions with nodular calcification may be at risk of stent under-expansion.
Background: Microvascular reperfusion following percutaneous coronary intervention (PCI) is associated with the prognosis of patients with ST-segment elevation myocardial infarction (STEMI). We investigated how plaque characteristics detected by optical coherence tomography (OCT) in STEMI patients affect the status of the microcirculation during PCI.
Methods and Results:This retrospective, single-center study was a post hoc analysis basedon the multicenter SALVAGE randomized control trial (NCT03581513) that enrolled 629 STEMI patients, and finally we enrolled 235 patients who underwent PCI and pre-intervention OCT. Microvascular perfusion was evaluated using the Thrombolysis in Myocardial Infarction (TIMI) myocardial perfusion frame count (TMPFC). Patients were divided into 3 groups based on the change in TMPFC from before to after PCI: improving TMPFC (n=11; 4.7%), stable TMPFC (n=182; 77.4%), and worsening TMPFC group (n=42; 17.9%). The proportion of patients with a microcirculation dysfunction before reperfusion was 11.9%, which increased significantly by (P=0.079) 8.5% to 20.4% after reperfusion. Compared with plaque characteristics in the stable and worsening TMPFC groups, the improving TMPFC group had fewer thrombi (90.7% and 90.5% vs. 89.4%, respectively; P=0.018), a lower proportion of plaque rupture (66.5% and 66.3% vs. 54.5%, respectively; P=0.029), and a lower proportion of lipid-rich plaques (89.6% and 88.1% vs. 63.6%, respectively; P=0.036).Conclusions: PCI may not always achieve complete myocardial reperfusion. Thrombi, plaque rupture, and lipid-rich plaques detected by OCT can indicate microcirculation dysfunction during the reperfusion period.
BACKGROUND: Coronary heart disease (CHD) significantly impacts human health. Traditional Chinese medicine (TCM) suggests a possible correlation between eye-image and CHD, but this relationship has not been fully explored in Western medicine. PURPOSE: We aim to investigate the potential causal relationship between eye-image features and CHD, as examined by coronary angiography (CAG). METHODS: The study selected patients hospitalized in the Department of Cardiology from November 15, 2021, to February 27, 2022. The selected patients were divided into two groups based on their CAG findings: the CHD group (at least one coronary lesion stenosis≥ 50%) and the control group (lesion stenosis<50%) RESURTS: The final analysis included 342 patients out of a total of 426 participants, of these, 165 patients (48.2%) were diagnosed with CHD. The study found that certain characteristics in the left region 5(L5) and right region ( R5) were associated with CHD, including L5 pink dark speckle (OR: 4.143, 95%CI: 1.135-15.124, P=0.031), L5 vascular tortuosity (OR: 0.234, 95%CI: 0.077- 0.71, P=0.010) R5 dark red blood vessels (known as Xue mai in TCM) (OR: 1.683, 95%CI: 1.035-2.738, P=0.036), and R5 yellowish mounds (OR: 2.083, 95%CI: 1.221-3.554, P= 0.007). Multivariate regression analyses showed that L5 vascular tortuosity had a negative correlation with CHD. CONCLUSION: Our study revealed that four types of eye-image features, namely pink dark speckle, vascular tortuosity, dark red blood vessels, and yellowish mounds are associated with CHD. Among these features, vascular tortuosity showed a negative correlation with CHD, which could potentially aid in the diagnosis of the disease. Key words: Eye-image; Coronary heart disease; Traditional Chinese medicine
Objectives: This study aimed to compare the effect of atorvastatin 60 (AT60) mg to that of rosuvastatin 10 (RT10) mg on the morphological changes in lipid-rich plaques (LRPs) and plaque volume, using serial optical coherence tomography (OCT) and intravascular ultrasound imaging (IVUS).Background: Intensive lipid lowering therapy by statin provides more clinical benefit compared to that of moderate lipid lowering therapy.Methods: Fifty patients who underwent OCT and IVUS at baseline, 6, and 12 months were grouped by statin therapy into the AT60 mg (n = 27) and RT10 mg (n = 23) groups. The relationships between absolute and percentage changes in biomarkers and fibrous cap thickness (FCT) during follow-up were investigated using a simple regression analysis.Results: At 6 months, the mean low-density lipoprotein cholesterol level reduced from 113.5 to 65.5 mg/dl (AT60 mg group) and 100.2 to 72.2 mg/dl (RT10 mg groups). A continuous increase in FCT from baseline to 12 months was observed in both groups (p < .001, p < .001, respectively). Mean lipid arc significantly decreased
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