Optical Coherence Tomographic Features of Pancoronary Plaques in Patients With Acute Myocardial Infarction Caused by Layered Plaque Rupture Versus Layered Plaque Erosion

Yin, Yan-Wei; Fang, Chao; Jiang, Shuang; Wang, J F; Wang, Yidan; Guo, Junchen; Lei, Fangmeng; Sun, Sibo; Pei, Xueying; Jia, Ruyi; Tang, Caiying; Zhang, Shaotao; Li, Lulu; Wang, Yini; Hou, Yu; Dai, Jihong; Yu, Bo

doi:10.1016/j.amjcard.2021.11.051

“…The selection of surviving literature is likely huge, the quality of the literature is low, and the accuracy of the above research effect will probably have an impact. It is proposed to pay attention to the random steps, blinding, and distribution concealment in future clinical seminars and hopes to present relevant clinical studies with multiple central and large samples to verify the effect of this study [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Meta-Analysis of the Effects of Recombinant Human Brain Natriuretic Peptides on Left Ventricular Remodeling in Patients with Acute Myocardial Infarction

Zhu

¹

2022

Computational and Mathematical Methods in Medicine

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Objective. Systematic evaluation of the efficacy of natriuretic recombination in human brain on disease myocardial infarction, left ventricular heart failure, and the efficacy and safety of long-term left ventricular remodeling. Methods. Computerized search of CNKI, Wanfang database, Wipro Chinese Technology Publications (VIP) numerical database, Chinese Biomedical Literature Database (CBM), Medline Cochrane Library, clinical Trail.Gov clinical collection, and other documents. Randomized controlled trials (RCT) of recombinant human brain natriuretic peptide in the treatment of acute myocardial infarction from inception to December 2021 were searched. Based on the Jadad scale, inclusion-exclusion data for diseases were collected and elaborated by meta by RevMan 5.3 simulation software. In a total of 23 randomized controlled trials, 2 024 cases were used as the basic data, the control group was routinely treated for 1 012 cases, and 1 012 cases in the experimental group were also treated with natriuretic peptide in the recombinant human brain on the previous basis. Results. In terms of overall efficacy, the experimental group was better than the control group, statistically significant ( OR = 4.30 , 95% CI (3.26, 5.67), P < 0.000 01 ), left ventricular ejection fraction in the experimental group than the control group ( OR = 1.58 , 95% CI (1.27, 1.90), P < 0.000 01 ). In terms of a myocardial strain in the left ventricle, the experimental group was superior to the control group. The difference was significant ( OR = − 0.91 , 95% CI (-1.50, -0.33), P = 0.002 ). In terms of the cardiac output volume, the experimental group was superior to the control group ( OR = 1.24 , 95% CI (0.55, 1.94), P = 0.0005 ). Regarding brain natriuretic peptide precursors, the experimental group was superior to the control group ( OR = − 4.37 , 95% CI (-6.21, -3.25), P < 0.00001 ). In terms of the heart rate, the experimental group was superior to the control group. Measurement of differential significance is as follows: OR = − 13.70 , 95% CI (-14.95, -12.46), P < 0.00001 . In terms of contraction, the experimental group was superior to the comparison group ( OR = − 12.38 , 95% CI (-17.98, -6.79), P < 0.00001 ). The experimental group outperformed the control group ( OR = − 7.42 , 95% CI (-8.53, -6.30), P < 0.00001 ). In terms of bad influence, the measurement is as follows: OR = 0.95 , 95% CI (0.29, 3.16), P = 0.94 . Conclusion. In patients with acute myocardial infarction and left ventricular remodeling, if treated with a heavy treatment of the group of cerebral natriuretic peptide mode, it can increase clinical treatment, improve the cardiac effect, inhibit ventricular remodeling, improve blood pressure and heart rhythm, and have greater clinical treatment and safety.

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“…This nding was rst proposed in autopsy studies, and approximately 3/4 of highly narrow coronary artery lesions and acute plaque rupture sites had layered plaques [2]. A recent OCT study demonstrated that layered plaques, exhibit heightened vulnerability [3], which is further manifested in the presence of layered plaques in non-target vessels.…”

Section: Introductionmentioning

confidence: 90%

Correlation between angiopoietin-2 and layered plaques in patients with acute coronary syndrome

Wen,

Yang,

Deng

et al. 2024

Preprint

0

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Objective Through a retrospective analysis of patients diagnosed with Acute coronary syndrome (ACS), relationships between Angiopoietin-2 (Ang2) and Optical coherence tomography (OCT) were investigated, especially in layered plaque. Methods In the analysis of patients’OCT image with ACS before operation, a total of 101 patients and 107 target vessels participated. Moreover, patients were divided into layered plaque (LP) group and non-layered plaque (NLP) group in accordance with whether target lesions of the patients had a layered plaque. Furthermore, Ang2 concentration was determined by ELISA. Binary Logistic regression model was employed to determine relationship between Ang2 and layered plaques, and ability of Ang2 to predict layered plaques as target lesions of ACS was determined by Receiver Operating Characteristic(ROC)curve. Results Between LP and NLP groups, there were substantial differences in Ang2 concentration. Besides, results of univariate and multivariate analysis indicated that Ang2 was an independent risk factor for layered plaques. Except for that, ROC illustrated that AUC of Ang2 level for predicting layered plaques, and optimum cut-off value was determined by Jorden index (15.045ng/mL). Conclusions In comparison with NLP groups, Ang2 levels in patients with ACS in the LP group were substantially higher than those in the NLP group. Other than that, concentration of Ang2 emerged as a standalone predictor for layered plaques.

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“…PCI can be performed in patients with MINOCA caused by atherosclerotic plaque rupture associated with MB [71]. However, PCI in the context of MB may be technically challenging and portend a higher risk of short-and long-term complications [72].…”

Section: Percutaneous Coronary Intervention (Pci)mentioning

confidence: 99%

“…PCI has been associated with both hemodynamic and symptom improvements in MB [78]. The use of high-radial-strength second-generation drug-eluting stents combined with accurate stent sizing using intravascular imaging may potentially improve outcomes in this setting by reducing the risk of stent fracture, stent thrombosis, perforation during stent deployment and in-stent restenosis [71]. Specific factors favouring PCI in MB include a shorter lesion length (<25 mm) and a more superficial depth (<2 mm) of the tunnelled segment.…”

Section: Percutaneous Coronary Intervention (Pci)mentioning

confidence: 99%

MINOCA Associated with a Myocardial Bridge: Pathogenesis, Diagnosis and Treatment

Rinaldi

¹

,

Princi

²

,

Vecchia

³

et al. 2023

JCM

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Myocardial bridging (MB) is the most frequent congenital coronary anomaly characterized by a segment of an epicardial coronary artery that passes through the myocardium. MB is an important cause of myocardial ischemia and is also emerging as a possible cause of myocardial infarction with non-obstructed coronary arteries (MINOCA). There are multiple mechanisms underlying MINOCA in patients with MB (i.e., MB-mediated increased risk of epicardial or microvascular coronary spasm, atherosclerotic plaque disruption and spontaneous coronary artery dissection). The identification of the exact pathogenetic mechanism is crucial in order to establish a patient-tailored therapy. This review provides the most up-to-date evidence regarding the pathophysiology of MINOCA in patients with MB. Moreover, it focuses on the available diagnostic tools that could be implemented at the time of coronary angiography to achieve a pathophysiologic diagnosis. Finally, it focuses on the therapeutic implications associated with the different pathogenetic mechanisms of MINOCA in patients with MB.

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Optical Coherence Tomographic Features of Pancoronary Plaques in Patients With Acute Myocardial Infarction Caused by Layered Plaque Rupture Versus Layered Plaque Erosion

Cited by 5 publications

References 25 publications

Meta-Analysis of the Effects of Recombinant Human Brain Natriuretic Peptides on Left Ventricular Remodeling in Patients with Acute Myocardial Infarction

Meta-Analysis of the Effects of Recombinant Human Brain Natriuretic Peptides on Left Ventricular Remodeling in Patients with Acute Myocardial Infarction

Correlation between angiopoietin-2 and layered plaques in patients with acute coronary syndrome

MINOCA Associated with a Myocardial Bridge: Pathogenesis, Diagnosis and Treatment

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