Optical coherence tomography-guided assessment for spontaneous coronary artery dissection in NSTEMI: OCT as a game changer

Dallan, Luís Augusto Palma; Gabasha, Shayef; Filby, Steven J.

doi:10.1007/s10554-022-02720-x

Cited by 2 publications

(1 citation statement)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The study reveals that patients with primarily red thrombus in the IRA tend to have occlusive lesions, while those with primarily white thrombus in the IRA tend to have non-occlusive lesions. We innovatively used OCT technology to observe coronary thrombus in NSTEMI patients, Luis Augusto Palma Dallan et al found that OCT-proven images completely changed the treatment of patients, mainly manifested by further improvement of treatment plans, including adequate pre-dilation and ideal stent size with good treatment outcomes [22]. If the IRA shown by our OCT are red thrombus/mixed thrombus, whether the one-size-tsall treatment strategy can be interrupted to perform thrombolytic therapy for these NSTEMI patients is a question worth exploring.…”

Section: Discussionmentioning

confidence: 99%

Optical Coherence Tomography Analysis of Lesion Characteristics and Thrombus Types in Non ST-Segment Elevation Myocardial Infarction Patients

He,

Yu,

et al. 2023

Preprint

View full text Add to dashboard Cite

Background: The precise features of lesions in non-ST-segment elevation myocardial infarction (NSTEMI) patients with total occlusion (TO) of the infarct-related artery (IRA) are still unclear. This study employs optical coherence tomography (OCT) to investigate pathological features in NSTEMI patients with or without IRA TO and explores the relationship between thrombus types and IRA occlusion. Methods:This was a single-center retrospective study. A total of 202 patients diagnosed with non-ST elevation myocardial infarction (NSTEMI) were divided into two groups: those with Thrombolysis In Myocardial Infarction (TIMI) flow grade 0 before percutaneous coronary intervention (PCI) (referred to as the TO group, n=100) and those TIMI flow grade 1-3 (referred to as the Non-TO group, n=102). Baseline characteristics, coronary angiography findings, and OCT results were collected. Multivariate logistic analysis identified factors influencing TO in NSTEMI. The category of NSTEMI was further subdivided based on the type of electrocardiogram (ECG) into two subgroups: ST segment unoffset myocardial infarction (STUMI) and ST segment depression myocardial infarction (STDMI). This division allows for a more specific classification of NSTEMI cases. Results:The TO group had a younger age, higher male representation, more smokers, lower hypertension and cerebrovascular disease incidence, lower left ventricular ejection fraction (LVEF), and higher creatine kinase myocardial band (CKMB) and creatine kinase (CK) peak levels. In the TO group, LCX served as the main IRA (52.0%), whereas in the Non-TO group, LAD was the predominant IRA (45.1%). Compared to the Non-TO group, OCT findings demonstrated that red thrombus/mixed thrombus was more common in the TO group, along with a lower occurrence of white thrombus (P<0.001). The TO group exhibited a higher prevalence of STUMI (P=0.001), whereas STDMI was more commonly observed in the Non-TO group (P=0.001). Conclusion: NSTEMI presents as STUMI and STDMI distinct entities. Red thrombus/mixed thrombus in IRA often indicates occlusive lesions with STUMI on ECG. White thrombus suggests non-occlusive lesions with STDMI on ECG.

show abstract

Section: Discussionmentioning

confidence: 99%

Optical Coherence Tomography Analysis of Lesion Characteristics and Thrombus Types in Non ST-Segment Elevation Myocardial Infarction Patients

He,

Yu,

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

Optical coherence tomography analysis of lesion characteristics and thrombus types in non ST-segment elevation myocardial infarction patients

He,

Yu,

et al. 2024

Int J Cardiovasc Imaging

View full text Add to dashboard Cite

The precise features of lesions in non-ST-segment elevation myocardial infarction (NSTEMI) patients with total occlusion (TO) of the infarct-related artery (IRA) are still unclear. This study employs optical coherence tomography (OCT) to investigate pathological features in NSTEMI patients with or without IRA TO and explores the relationship between thrombus types and IRA occlusive status. This was a single-center retrospective study. A total of 202 patients diagnosed with NSTEMI were divided into two groups: those with Thrombolysis In Myocardial Infarction (TIMI) flow grade 0 before percutaneous coronary intervention (PCI) (referred to as the TO group, n = 100) and those TIMI flow grade 1–3 (referred to as the Non-TO group, n = 102). Baseline characteristics, coronary angiography findings, and OCT results were collected. Multivariate logistic analysis identified factors influencing TO in NSTEMI. The category of NSTEMI was further subdivided based on the type of electrocardiogram (ECG) into two subgroups: ST segment unoffset myocardial infarction (STUMI) and ST segment depression myocardial infarction (STDMI). This division allows for a more specific classification of NSTEMI cases. The TO group had a younger age, higher male representation, more smokers, lower hypertension and cerebrovascular disease incidence, lower left ventricular ejection fraction (LVEF), and higher creatine kinase myocardial band (CKMB) and creatine kinase (CK) peak levels. In the TO group, LCX served as the main IRA (52.0%), whereas in the Non-TO group, LAD was the predominant IRA (45.1%). Compared to the Non-TO group, OCT findings demonstrated that red thrombus/mixed thrombus was more common in the TO group, along with a lower occurrence of white thrombus (p < 0.001). The TO group exhibited a higher prevalence of STUMI (p = 0.001), whereas STDMI was more commonly observed in the Non-TO group (p = 0.001). NSTEMI presents as STUMI and STDMI distinct entities. Red thrombus/mixed thrombus in IRA often indicates occlusive lesions with STUMI on ECG. White thrombus suggests non-occlusive lesions with STDMI on ECG.

show abstract

Optical coherence tomography-guided assessment for spontaneous coronary artery dissection in NSTEMI: OCT as a game changer

Cited by 2 publications

References 3 publications

Optical Coherence Tomography Analysis of Lesion Characteristics and Thrombus Types in Non ST-Segment Elevation Myocardial Infarction Patients

Optical Coherence Tomography Analysis of Lesion Characteristics and Thrombus Types in Non ST-Segment Elevation Myocardial Infarction Patients

Optical coherence tomography analysis of lesion characteristics and thrombus types in non ST-segment elevation myocardial infarction patients

Contact Info

Product

Resources

About