The Relationship Between Attenuated Plaque Identified by Intravascular Ultrasound and No-Reflow After Stenting in Acute Myocardial Infarction

Wu, Xianren; Mintz, Gary S.; Xu, Kai; Lansky, Alexandra J.; Witzenbichler, Bernhard; Guagliumi, Giulio; Brodie, Bruce R.; Kellett, Mirle A.; Dressler, Ovidiu; Parise, Helen; Mehran, Roxana; Stone, Gregg W.; Maehara, Akiko

doi:10.1016/j.jcin.2010.12.012

Cited by 105 publications

(53 citation statements)

References 37 publications

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“…[1][2][3][4][5] Histological studies have shown that attenuated plaques contain more necrotic core and fibrofatty tissue or microcalcification compared with fibrous plaques without attenuation. 4,6,7 However, there are limited data on the evolution of attenuated plaques over time.…”

mentioning

confidence: 99%

Long-Term Follow-Up of Attenuated Plaques in Patients With Acute Myocardial Infarction

Mintz

Kubo

et al. 2012

Circ: Cardiovascular Interventions

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mentioning

confidence: 99%

Long-Term Follow-Up of Attenuated Plaques in Patients With Acute Myocardial Infarction

Mintz

Kubo

et al. 2012

Circ: Cardiovascular Interventions

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“…Attenuated plaques are associated with ST-segment elevation MI and no reflow in patients with CAD who undergo PCI (24). However, there has been no systemic review of the impact of attenuated plaques on TIMI grade and clinical outcomes of CAD patients and attenuated plaques are not described in the current IVUS guidelines from the American College of Cardiology or the European Society of Cardiology.…”

Section: Discussionmentioning

confidence: 99%

“…The meta-analysis by Ding S et al revealed that compared with patients with normal flow, significantly higher absolute necrotic core volume and dense calcium were found in ACS patients with distal embolization (32,33). The HORIZONS-AMI Trial showed that the larger the attenuated plaque is, the greater the likelihood of no-reflow is (24). However, Stone GW et al (7) found that, among 51 non-culprit-lesion related recurrent events occurring in the imaged segments, only 26 (51%) occurred at sites with thincap fibroatheromas while others were the most common thick-cap fibroatheromas.…”

Section: Discussionmentioning

confidence: 99%

Impact of attenuated plaques on TIMI grade flow and clinical outcomes of coronary artery disease patients: a systematic review and meta analysis

Nie¹,

Li²,

Zhu³

et al. 2016

J. Thorac. Dis.

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Background: Plaques with a large necrotic core or lipid pool and thin-cap fibroatheroma manifest as attenuated plaques on intravascular ultrasound (IVUS). Their impact on TIMI grade flow and clinical outcomes remains undefined. We performed a systematic review and meta-analysis to summarize the association between attenuated plaque and distal embolization and clinical outcomes of coronary artery disease (CAD) from pooled data of published eligible cohort studies. Methods:We searched the literature on TIMI grade flow and clinical outcomes on PubMed, Ovid, EMBASE, the Cochrane Library, CNKI and WanFang databases. Study heterogeneity and publication bias were estimated.Results: A total of 3,833 patients were enrolled in nine studies. Five studies investigated TIMI grade flow and attenuated plaques. They revealed no difference in TIMI grade flow before percutaneous coronary intervention (PCI) between the attenuated and non-attenuated plaque group (RR =1.25; 95% CI: 0.65 to 2.41; P=0.50).After balloon dilation and stent implantation, the incidence of TIMI 0~2 grade flow in the attenuated plaque group was statistically significant higher than that of the non-attenuated plaque group (RR =4.73; 95% CI: 3.03 to 7.40; P<0.001). Five other studies investigated major cardiovascular events (MACEs) and attenuated plaques and found no difference in MACE rates within three years of follow up.Conclusions: Our study presents the evidence that plaque with ultrasound signal attenuation would induce slow/no reflow phenomenon and distal embolization during PCI, but this appearance has no impact on MACE rates within three years.

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“…Histologically, attenuated plaques on IVUS correlate with a fibroatheroma containing large necrotic core or pathological intimal thickening (PIT) with a large lipid pool (22). Attenuated plaque is frequently observed at culprit lesion in patients with acute coronary syndrome (ACS) and is associated with deterioration of coronary flow and periprocedural myocardial infarction following PCI (23)(24)(25).…”

Section: Attenuated Plaquementioning

confidence: 99%

Characterization of coronary atherosclerosis by intravascular imaging modalities

Honda¹,

Kataoka²,

Kanaya³

et al. 2016

Cardiovasc. Diagn. Ther.

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Coronary artery disease (CAD) is highly prevalent in Western countries and is associated with morbidity, mortality, and a significant economic burden. Despite the development of anti-atherosclerotic medical therapies, many patients still continue to suffer from coronary events. This residual risk indicates the need for better risk stratification and additional therapies to achieve more reductions in cardiovascular risk.Recent advances in imaging modalities have contributed to visualizing atherosclerotic plaques and defining lesion characteristics in vivo. This innovation has been applied to refining revascularization procedure, assessment of anti-atherosclerotic drug efficacy and the detection of high-risk plaques. As such, intravascular imaging plays an important role in further improvement of cardiovascular outcomes in patients with CAD.The current article reviews available intravascular imaging modalities with regard to its method, advantage and disadvantage.

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The Relationship Between Attenuated Plaque Identified by Intravascular Ultrasound and No-Reflow After Stenting in Acute Myocardial Infarction

Cited by 105 publications

References 37 publications

Long-Term Follow-Up of Attenuated Plaques in Patients With Acute Myocardial Infarction

Long-Term Follow-Up of Attenuated Plaques in Patients With Acute Myocardial Infarction

Impact of attenuated plaques on TIMI grade flow and clinical outcomes of coronary artery disease patients: a systematic review and meta analysis

Characterization of coronary atherosclerosis by intravascular imaging modalities

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