Comparison of Coronary Arterial Finding by Intravascular Ultrasound in Patients With “Transient No-Reflow” Versus “Reflow” During Percutaneous Coronary Intervention in Acute Coronary Syndrome
Previous studies have shown that transient no-reflow during coronary intervention but with Thrombosis in Myocardial Infarction (TIMI) grade 3 flow at the completion of the procedure is associated with increased in-hospital and 6-month mortality. We hypothesized that the use of intravascular ultrasou...
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creator | Iijima, Raisuke Shinji, Hideo Ikeda, Nobutaka Itaya, Hideki Makino, Kunihiko Funatsu, Atsushi Yokouchi, Itaru Komatsu, Hirotaka Ito, Naoki Nuruki, Hiroya Nakajima, Rintaro Nakamura, Masato |
description | Previous studies have shown that transient no-reflow during coronary intervention but with Thrombosis in Myocardial Infarction (TIMI) grade 3 flow at the completion of the procedure is associated with increased in-hospital and 6-month mortality. We hypothesized that the use of intravascular ultrasound before intervention could identify morphologic features that were predictive of transient no-reflow in patients who had acute coronary syndrome (ACS). We analyzed 220 patients with ACS who had suitable intravascular ultrasound images that were acquired before intervention. We defined “transient no-reflow” as TIMI grade 0, 1, or 2 flow during the procedure and TIMI grade 3 flow at the completion of the procedure. We defined “reflow” as good coronary flow (TIMI grade 3 flow) during and after the procedure. Patients were categorized to a transient no-reflow group (n = 20) or a reflow group (n = 200). In the transient no-reflow group, vessel area and amount of plaque burden in the culprit lesion were significantly greater than in the reflow group (vessel 20.8 ± 5.4 vs 16.4 ± 6.2 mm
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doi_str_mv | 10.1016/j.amjcard.2005.07.104 |
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2, p <0.01; plaque burden 0.90 ± 0.03 vs 0.83 ± 0.08, p <0.001). The presence of ruptured plaque, lipid pool-like images, and thrombus formation were significantly higher in the transient no-reflow group than in the reflow group. Multivariate analysis identified the presence of thrombus formation (odds ratio 4.53, 95% confidence interval 1.03 to 20.0, p = 0.04) and larger plaque burden (odds ratio 1.79, 95% confidence interval 1.01 to 3.23, p = 0.05) as independent predictors of transient no-reflow. In conclusion, lesion morphologies are different for transient no-reflow and reflow. These findings suggest that the presence of thrombus formation and large plaque burden increase the risk for developing transient no-reflow during coronary intervention for ACS.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2005.07.104</identifier><identifier>PMID: 16377279</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aged ; Angina, Unstable - diagnostic imaging ; Angina, Unstable - therapy ; Angioplasty, Balloon, Coronary ; Biological and medical sciences ; Blood vessels ; Cardiology. Vascular system ; Cardiovascular disease ; Comparative analysis ; Coronary Artery Disease - diagnostic imaging ; Coronary Circulation ; Coronary heart disease ; Coronary Thrombosis - diagnostic imaging ; Coronary vessels ; Coronary Vessels - diagnostic imaging ; Creatine Kinase - blood ; Female ; Heart ; Humans ; Male ; Medical sciences ; Middle Aged ; Multivariate Analysis ; Myocardial Infarction - diagnostic imaging ; Myocardial Infarction - therapy ; Patients ; Stents ; Stroke Volume ; Ultrasonic imaging ; Ultrasonography, Interventional</subject><ispartof>The American journal of cardiology, 2006, Vol.97 (1), p.29-33</ispartof><rights>2006 Elsevier Inc.</rights><rights>2006 INIST-CNRS</rights><rights>Copyright Elsevier Sequoia S.A. Jan 1, 2006</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c420t-507207908ed781fd82842bc843bda1ebfe5e50f286924485eddc3d82221433693</citedby><cites>FETCH-LOGICAL-c420t-507207908ed781fd82842bc843bda1ebfe5e50f286924485eddc3d82221433693</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.amjcard.2005.07.104$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,781,785,3551,4025,27928,27929,27930,46000</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17426839$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16377279$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Iijima, Raisuke</creatorcontrib><creatorcontrib>Shinji, Hideo</creatorcontrib><creatorcontrib>Ikeda, Nobutaka</creatorcontrib><creatorcontrib>Itaya, Hideki</creatorcontrib><creatorcontrib>Makino, Kunihiko</creatorcontrib><creatorcontrib>Funatsu, Atsushi</creatorcontrib><creatorcontrib>Yokouchi, Itaru</creatorcontrib><creatorcontrib>Komatsu, Hirotaka</creatorcontrib><creatorcontrib>Ito, Naoki</creatorcontrib><creatorcontrib>Nuruki, Hiroya</creatorcontrib><creatorcontrib>Nakajima, Rintaro</creatorcontrib><creatorcontrib>Nakamura, Masato</creatorcontrib><title>Comparison of Coronary Arterial Finding by Intravascular Ultrasound in Patients With “Transient No-Reflow” Versus “Reflow” During Percutaneous Coronary Intervention in Acute Coronary Syndrome</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>Previous studies have shown that transient no-reflow during coronary intervention but with Thrombosis in Myocardial Infarction (TIMI) grade 3 flow at the completion of the procedure is associated with increased in-hospital and 6-month mortality. We hypothesized that the use of intravascular ultrasound before intervention could identify morphologic features that were predictive of transient no-reflow in patients who had acute coronary syndrome (ACS). We analyzed 220 patients with ACS who had suitable intravascular ultrasound images that were acquired before intervention. We defined “transient no-reflow” as TIMI grade 0, 1, or 2 flow during the procedure and TIMI grade 3 flow at the completion of the procedure. We defined “reflow” as good coronary flow (TIMI grade 3 flow) during and after the procedure. Patients were categorized to a transient no-reflow group (n = 20) or a reflow group (n = 200). In the transient no-reflow group, vessel area and amount of plaque burden in the culprit lesion were significantly greater than in the reflow group (vessel 20.8 ± 5.4 vs 16.4 ± 6.2 mm
2, p <0.01; plaque burden 0.90 ± 0.03 vs 0.83 ± 0.08, p <0.001). The presence of ruptured plaque, lipid pool-like images, and thrombus formation were significantly higher in the transient no-reflow group than in the reflow group. Multivariate analysis identified the presence of thrombus formation (odds ratio 4.53, 95% confidence interval 1.03 to 20.0, p = 0.04) and larger plaque burden (odds ratio 1.79, 95% confidence interval 1.01 to 3.23, p = 0.05) as independent predictors of transient no-reflow. In conclusion, lesion morphologies are different for transient no-reflow and reflow. These findings suggest that the presence of thrombus formation and large plaque burden increase the risk for developing transient no-reflow during coronary intervention for ACS.</description><subject>Aged</subject><subject>Angina, Unstable - diagnostic imaging</subject><subject>Angina, Unstable - therapy</subject><subject>Angioplasty, Balloon, Coronary</subject><subject>Biological and medical sciences</subject><subject>Blood vessels</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular disease</subject><subject>Comparative analysis</subject><subject>Coronary Artery Disease - diagnostic imaging</subject><subject>Coronary Circulation</subject><subject>Coronary heart disease</subject><subject>Coronary Thrombosis - diagnostic imaging</subject><subject>Coronary vessels</subject><subject>Coronary Vessels - diagnostic imaging</subject><subject>Creatine Kinase - blood</subject><subject>Female</subject><subject>Heart</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Myocardial Infarction - diagnostic imaging</subject><subject>Myocardial Infarction - therapy</subject><subject>Patients</subject><subject>Stents</subject><subject>Stroke Volume</subject><subject>Ultrasonic imaging</subject><subject>Ultrasonography, Interventional</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkcFu1DAQhiMEokvhEUAWEtyy2E5iOye0WihUqqCCFo6WY0_Aq8Te2smivfVB4Hl4jz4JjjZiJS6crPn9zcxv_1n2lOAlwYS92ixVv9EqmCXFuFpinuTyXrYggtc5qUlxP1tgjGlek7I-yR7FuEklIRV7mJ0QVnBOeb3Ifq99v1XBRu-Qb9HaB-9U2KNVGCBY1aEz64x131CzR-duCGqnoh47FdB1l6roR2eQdehSDRbcENFXO3xHd7c_r4JycZLQB59_grbzP-5uf6EvEOIYJ-CovRnDtOESgh4H5cAn4K-RtBTCLs2xyWFatEoMHK8_750JvofH2YNWdRGezOdpdn329mr9Pr_4-O58vbrIdUnxkFeYU8xrLMBwQVojqChpo0VZNEYRaFqooMItFaymZSkqMEYXiaKUlEXB6uI0e3mYuw3-ZoQ4yN5GDV138C0ZrwTDVCTw-T_gxo_BJW-SFrhgrGI4QdUB0sHHGKCV22D79C5JsJxilhs5xyynmCXmSS5T37N5-Nj0YI5dc64JeDEDKS7VtSkMbeOR4yVlopi41wcO0p_tLAQZdQpNg7EB9CCNt_-x8gd9s9AG</recordid><startdate>2006</startdate><enddate>2006</enddate><creator>Iijima, Raisuke</creator><creator>Shinji, Hideo</creator><creator>Ikeda, Nobutaka</creator><creator>Itaya, Hideki</creator><creator>Makino, Kunihiko</creator><creator>Funatsu, Atsushi</creator><creator>Yokouchi, Itaru</creator><creator>Komatsu, Hirotaka</creator><creator>Ito, Naoki</creator><creator>Nuruki, Hiroya</creator><creator>Nakajima, Rintaro</creator><creator>Nakamura, Masato</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>2006</creationdate><title>Comparison of Coronary Arterial Finding by Intravascular Ultrasound in Patients With “Transient No-Reflow” Versus “Reflow” During Percutaneous Coronary Intervention in Acute Coronary Syndrome</title><author>Iijima, Raisuke ; Shinji, Hideo ; Ikeda, Nobutaka ; Itaya, Hideki ; Makino, Kunihiko ; Funatsu, Atsushi ; Yokouchi, Itaru ; Komatsu, Hirotaka ; Ito, Naoki ; Nuruki, Hiroya ; Nakajima, Rintaro ; Nakamura, Masato</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c420t-507207908ed781fd82842bc843bda1ebfe5e50f286924485eddc3d82221433693</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Aged</topic><topic>Angina, Unstable - diagnostic imaging</topic><topic>Angina, Unstable - therapy</topic><topic>Angioplasty, Balloon, Coronary</topic><topic>Biological and medical sciences</topic><topic>Blood vessels</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular disease</topic><topic>Comparative analysis</topic><topic>Coronary Artery Disease - diagnostic imaging</topic><topic>Coronary Circulation</topic><topic>Coronary heart disease</topic><topic>Coronary Thrombosis - diagnostic imaging</topic><topic>Coronary vessels</topic><topic>Coronary Vessels - diagnostic imaging</topic><topic>Creatine Kinase - blood</topic><topic>Female</topic><topic>Heart</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Myocardial Infarction - diagnostic imaging</topic><topic>Myocardial Infarction - therapy</topic><topic>Patients</topic><topic>Stents</topic><topic>Stroke Volume</topic><topic>Ultrasonic imaging</topic><topic>Ultrasonography, Interventional</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Iijima, Raisuke</creatorcontrib><creatorcontrib>Shinji, Hideo</creatorcontrib><creatorcontrib>Ikeda, Nobutaka</creatorcontrib><creatorcontrib>Itaya, Hideki</creatorcontrib><creatorcontrib>Makino, Kunihiko</creatorcontrib><creatorcontrib>Funatsu, Atsushi</creatorcontrib><creatorcontrib>Yokouchi, Itaru</creatorcontrib><creatorcontrib>Komatsu, Hirotaka</creatorcontrib><creatorcontrib>Ito, Naoki</creatorcontrib><creatorcontrib>Nuruki, Hiroya</creatorcontrib><creatorcontrib>Nakajima, Rintaro</creatorcontrib><creatorcontrib>Nakamura, Masato</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Iijima, Raisuke</au><au>Shinji, Hideo</au><au>Ikeda, Nobutaka</au><au>Itaya, Hideki</au><au>Makino, Kunihiko</au><au>Funatsu, Atsushi</au><au>Yokouchi, Itaru</au><au>Komatsu, Hirotaka</au><au>Ito, Naoki</au><au>Nuruki, Hiroya</au><au>Nakajima, Rintaro</au><au>Nakamura, Masato</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of Coronary Arterial Finding by Intravascular Ultrasound in Patients With “Transient No-Reflow” Versus “Reflow” During Percutaneous Coronary Intervention in Acute Coronary Syndrome</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2006</date><risdate>2006</risdate><volume>97</volume><issue>1</issue><spage>29</spage><epage>33</epage><pages>29-33</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract>Previous studies have shown that transient no-reflow during coronary intervention but with Thrombosis in Myocardial Infarction (TIMI) grade 3 flow at the completion of the procedure is associated with increased in-hospital and 6-month mortality. We hypothesized that the use of intravascular ultrasound before intervention could identify morphologic features that were predictive of transient no-reflow in patients who had acute coronary syndrome (ACS). We analyzed 220 patients with ACS who had suitable intravascular ultrasound images that were acquired before intervention. We defined “transient no-reflow” as TIMI grade 0, 1, or 2 flow during the procedure and TIMI grade 3 flow at the completion of the procedure. We defined “reflow” as good coronary flow (TIMI grade 3 flow) during and after the procedure. Patients were categorized to a transient no-reflow group (n = 20) or a reflow group (n = 200). In the transient no-reflow group, vessel area and amount of plaque burden in the culprit lesion were significantly greater than in the reflow group (vessel 20.8 ± 5.4 vs 16.4 ± 6.2 mm
2, p <0.01; plaque burden 0.90 ± 0.03 vs 0.83 ± 0.08, p <0.001). The presence of ruptured plaque, lipid pool-like images, and thrombus formation were significantly higher in the transient no-reflow group than in the reflow group. Multivariate analysis identified the presence of thrombus formation (odds ratio 4.53, 95% confidence interval 1.03 to 20.0, p = 0.04) and larger plaque burden (odds ratio 1.79, 95% confidence interval 1.01 to 3.23, p = 0.05) as independent predictors of transient no-reflow. In conclusion, lesion morphologies are different for transient no-reflow and reflow. These findings suggest that the presence of thrombus formation and large plaque burden increase the risk for developing transient no-reflow during coronary intervention for ACS.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>16377279</pmid><doi>10.1016/j.amjcard.2005.07.104</doi><tpages>5</tpages></addata></record> |
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subjects | Aged Angina, Unstable - diagnostic imaging Angina, Unstable - therapy Angioplasty, Balloon, Coronary Biological and medical sciences Blood vessels Cardiology. Vascular system Cardiovascular disease Comparative analysis Coronary Artery Disease - diagnostic imaging Coronary Circulation Coronary heart disease Coronary Thrombosis - diagnostic imaging Coronary vessels Coronary Vessels - diagnostic imaging Creatine Kinase - blood Female Heart Humans Male Medical sciences Middle Aged Multivariate Analysis Myocardial Infarction - diagnostic imaging Myocardial Infarction - therapy Patients Stents Stroke Volume Ultrasonic imaging Ultrasonography, Interventional |
title | Comparison of Coronary Arterial Finding by Intravascular Ultrasound in Patients With “Transient No-Reflow” Versus “Reflow” During Percutaneous Coronary Intervention in Acute Coronary Syndrome |
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