期刊
CIRCULATION JOURNAL
卷 79, 期 9, 页码 1944-U270出版社
JAPANESE CIRCULATION SOC
DOI: 10.1253/circj.CJ-14-1375
关键词
Angina; Biomarker; Intravascular ultrasound; Optical coherence tomography; Outcome
Background: Periprocedural myocardial injury (PMI) is not an uncommon complication and is related to adverse cardiac events after percutaneous coronary intervention (PCI). We investigated the predictors of PMI in patients with stable angina pectoris (SAP) on intravascular imaging. Methods and Results: We enrolled 193 SAP patients who underwent pre-PCI intravascular ultrasound (IVUS) and optical coherence tomography (OCT). Clinical characteristics, lesion morphology, and long-term follow-up data were compared between patients with and without PMI, defined as post-PCI elevation of high-sensitivity cardiac troponin-T. PMI were observed in 79 patients (40.9%). Estimated glomerular filtration rate (odds ratio [OR], 0.973; 95% confidence interval [CI]: 0.950-0.996; P= 0.020), >= 2 stents (OR, 3.100; 95% CI: 1.334-7.205; P= 0.009), final myocardial blush grade 0-2 (OR, 4.077; 95% CI: 1.295-12.839; P= 0.016), and IVUS-identified echo-attenuated plaque (EA; OR, 3.623; 95% CI: 1.700-7.721; P< 0.001) and OCT-derived thin-cap fibroatheroma (OCT-TCFA; OR, 3.406; 95% CI: 1.307-8.872; P= 0.012) were independent predictors of PMI on multivariate logistic regression analysis. A combination of EA and OCT-TCFA had an 82.4% positive predictive value for PMI. On Cox proportional hazards analysis, PMI was an independent predictor of adverse cardiac events during 1-year follow-up (hazard ratio, 2.984; 95% CI: 1.209-7.361; P= 0.018). Conclusions: Plaque morphology assessment using pre-PCI IVUS and OCT may be useful for predicting PMI in SAP patients.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据