The influence of attenuated plaque on perioperative period of percutaneous coronary intervention in patients with acute myocardial infarction
10.3969/j.issn.1008-794X.2015.10.004
- VernacularTitle:衰减斑块对急性心肌梗死患者经皮冠状动脉介入治疗围术期的影响研究
- Author:
Hong LI
;
Zening JIN
;
Duo YANG
;
Xiang LI
;
Huagang ZHU
;
Ruofei JIA
;
Shuai MENG
- Publication Type:Journal Article
- Keywords:
attenuated plaque;
endovascular ultrasound;
acute myocardial infarction;
TIMI flow classification;
creatine kinase MB
- From:
Journal of Interventional Radiology
2015;(10):849-852
- CountryChina
- Language:Chinese
-
Abstract:
Objective To detect attenuated plaque by using intravascular ultrasound (IVUS) in patients with acute myocardial infarction (AMI) and to investigate the influence of attenuated plaque on perioperative period of percutaneous coronary intervention (PCI). Methods Coronary angiography and IVUS were performed in 85 hospitalized patients with AMI, additional implantation of stent was employed when necessary. According to the presence or absence of attenuated plaque determined by IVUS, the patients were divided into attenuated plaque group(n=35) and non-attenuated plaque group(n=50). The perioperative IVUS findings, the blood flow classification after myocardial infarction thrombolysis (TIMI) and the postoperative peak value of creatine kinase MB (CK-MB) determined were compared between the two groups. Results Among the 85 AMI patients, attenuated plaque was detected in 35 (41.2%) and no attenuated plaque was found in 50(58.8%). No statistically significant differences in the age, sex and risk factors existed between the two groups (P>0.05). The proportion of having attenuated plaque in patients with ST segment elevation myocardial infarction (STEMI) was obviously higher than that in patients with non-STEMI (P<0.01). In performing coronary angiography, the difference in TIMI blood flow classification between the two groups was not statistically significant (P>0.05), but after balloon dilatation the TIMI grade 0-2 in theattenuated plaque group was strikingly higher than that in the non-attenuated plaque group (P=0.003). After PCI, the proportion of patients with elevated CK-MB value and higher peak value in the attenuated plaque group was remarkably higher than those in the non-attenuated plaque group (P<0.01). Conclusion The results of this study indicate that attenuated plaque can increase the incidence of no-reflow and slow reflow after PCI, which is more often seen in STEMI patients. The attenuated plaque carries significantly high risk, and the presence of attenuated plaque is helpful in predicting, the elevated extent of CK-MB value after PCI.
