Determinants of Slow Flow in Percutaneous Coronary Intervention to the Culprit Lesion of Non-ST Elevation Myocardial Infarction

Abstract

Slow flow is a serious complication in percutaneous coronary intervention (PCI) and is associated with poor clinical outcomes. Our previous study revealed that the ratio of stent diameter to vessel diameter was the determinant of slow flow in intravascular ultrasound (IVUS)-guided PCI to the culprit lesion of ST elevation myocardial infarction (STEMI). The purpose of this study was to verify whether the ratio of stent diameter to vessel diameter is the determinant of slow flow in IVUS-guided PCI to the culprit lesion of non-STEMI (NSTEMI). We included 150 NSTEMI patients and divided into the slow flow group (n = 17) and the non-slow flow group (n = 133). The ratio of stent diameter to vessel diameter was significantly larger in the slow flow group (0.77 ± 0.11) than the non-slow flow group (0.71 ± 0.11) (P = 0.03). Multivariate logistic regression analysis revealed that the ratio of stent diameter to vessel diameter (per 0.1 increase: OR 2.06, 95% CI 1.23-3.46, P = 0.006) was the determinant of slow flow after controlling covariates. In conclusion, the ratio of stent diameter to vessel diameter was the determinant of slow flow in IVUS-guided PCI to the culprit lesion of NSTEMI. Unlike other parameters, the ratio of stent diameter to vessel diameter is the modifiable parameters. We may consider the modest stent expansion strategy rather than the aggressive stent expansion strategy in IVUS-guided PCI to the culprit lesion of NSTEMI.

Clinical Factors Associated with In-Hospital Mortality in Patients with Acute Myocardial Infarction Who Required Intra-Aortic Balloon Pumping

“…Hypertension was defined as either medical treatment with oral anti-hypertensive medicines or a history of hypertension before admission. 8,9) Dyslipidemia was defined as a total cholesterol level 220 mg/dL and over, a low-density lipoprotein cholesterol level 140 mg/dL and over, or treatment for dyslipidemia. 10) Diabetes mellitus was defined as hemoglobin A1c level 6.5% and over or medical treatment with anti-hyperglycemia medicines.…”

Association of the long fluoroscopy time with factors in contemporary primary percutaneous coronary interventions

“…Hypertension was defined as medical treatment for hypertension and/or a history of hypertension before admission [10]. Dyslipidemia was defined as a total cholesterol level � 220 mg/dL or low-density lipoprotein cholesterol level � 140 mg/dL or medical treatment for dyslipidemia or a history of dyslipidemia [10]. Diabetes mellitus was defined as a hemoglobin A1c level � 6.5% (as NGSP value) or medical treatment for diabetes mellitus or a history of diabetes mellitus [10].…”

Determinants of Insufficient Optimal Medical Therapy after Acute Myocardial Infarction

“…Dyslipidemia was defined as a total cholesterol level " 220 mg/dL or a low-density lipoprotein cholesterol level " 140 mg/dL or medical treatment for dyslipidemia (9). Diabetes mellitus was defined as a hemoglobin A1c level " 6.5% (as NGSP value) or medical treatment for diabetes mellitus (12). We also calculated the estimated glomerular filtration rate (eGFR) from the serum creatinine levels, age, weight, and gender using the following formula: eGFR =194× Cr −1.094 × age −0.287 (male), eGFR = 194× Cr −1.094 × age −0.287 ×0.739 (female) (13).…”