共查询到20条相似文献，搜索用时 31 毫秒
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Chee Yang Chin Mitsuaki Matsumura Akiko Maehara Wenbin Zhang Cheolmin Tetsumin Lee Myong Hwa Yamamoto Lei Song Yasir Parviz Nisha B. Jhalani Sumit Mohan Lloyd E. Ratner David J. Cohen Ori Ben-Yehuda Gregg W. Stone Richard A. Shlofmitz Tsunekazu Kakuta Gary S. Mintz Ziad A. Ali 《The American journal of cardiology》2017,119(9):1313-1319
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Yoshiki Matsuo Daisuke Higashioka Yasushi Ino Yasutsugu Shiono Hironori Kitabata Kosei Terada Hiroki Emori Yosuke Katayama Akira Taruya Tsuyoshi Nishiguchi Kunihiro Shimamura Takeyoshi Kameyama Akio Kuroi Takashi Yamano Takashi Tanimoto Atsushi Tanaka Takeshi Hozumi Takashi Kubo Takashi Akasaka 《JACC: Cardiovascular Imaging》2019,12(6):1103-1105
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Eisuke Usui Taishi Yonetsu Yoshihisa Kanaji Masahiro Hoshino Masao Yamaguchi Masahiro Hada Tadashi Fukuda Yohei Sumino Hiroaki Ohya Rikuta Hamaya Yoshinori Kanno Haruhito Yuki Tadashi Murai Tetsumin Lee Kenzo Hirao Tsunekazu Kakuta 《JACC: Cardiovascular Interventions》2018,11(20):2058-2068
Objectives
This study sought to investigate the relationship of unstable plaque features with physiological lesion severity and microvascular dysfunction.Background
The functional severity of epicardial lesions and microvascular dysfunction are both related to adverse clinical outcomes.Methods
We investigated 382 de novo intermediate and severe coronary lesions in 340 patients who underwent optical coherence tomography, fractional flow reserve (FFR), and index of microcirculatory resistance (IMR) examinations. Lesions were divided into tertiles based on either FFR or IMR values. The optical coherence tomography findings were compared among the tertiles of FFR and IMR. Each tertile was defined as follows: FFR-T1 (FFR <0.74), FFR-T2 (0.74 ≤ FFR ≤0.81), and FFR-T3 (FFR >0.81); and IMR-T1 (IMR ≥25), IMR-T2 (15 < IMR <25), and IMR-T3 (IMR ≤15).Results
No significant relationship was observed between FFR and IMR. The prevalence of optical coherence tomography–defined thin-cap fibroatheroma (TCFA) was significantly greater in IMR-T1 than in IMR-T2 and IMR-T3. An overall significant difference in the prevalence of TCFAs was detected among FFR tertiles, although no pairwise comparison revealed statistical significance. The prevalence of ruptured plaque was significantly greater in IMR-T1 than in IMR-T2 and IMR-T3, although no significant difference was observed between FFR tertiles. Multivariate analysis showed that FFR and IMR were independent predictors of the prevalence of TCFAs (odds ratio: 0.036; 95% confidence interval: 0.004 to 0342; p = 0.004; and odds ratio: 1.034; 95% confidence interval: 1.014 to 1.054; p = 0.001, respectively).Conclusions
Lower FFR and higher IMR values were independent predictors of the presence of a TCFA in angiographically intermediate-to-severe stable lesions or nonculprit lesions in acute coronary syndrome. 相似文献8.
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Daniel A. Jones Krishnaraj S. Rathod Sudheer Koganti Stephen Hamshere Zoe Astroulakis Pitt Lim Alexander Sirker Constantinos O’Mahony Ajay K. Jain Charles J. Knight Miles C. Dalby Iqbal S. Malik Anthony Mathur Roby Rakhit Tim Lockie Simon Redwood Philip A. MacCarthy Ranil Desilva Christos V. Bourantas 《JACC: Cardiovascular Interventions》2018,11(14):1313-1321
Objectives
This study aimed to determine the effect on long-term survival of using optical coherence tomography (OCT) during percutaneous coronary intervention (PCI).Background
Angiographic guidance for PCI has substantial limitations. The superior spatial resolution of OCT could translate into meaningful clinical benefits, although limited data exist to date about their effect on clinical endpoints.Methods
This was a cohort study based on the Pan-London (United Kingdom) PCI registry, which includes 123,764 patients who underwent PCI in National Health Service hospitals in London between 2005 and 2015. Patients undergoing primary PCI or pressure wire use were excluded leaving 87,166 patients in the study. The primary endpoint was all-cause mortality at a median of 4.8 years.Results
OCT was used in 1,149 (1.3%) patients, intravascular ultrasound (IVUS) was used in 10,971 (12.6%) patients, and angiography alone in the remaining 75,046 patients. Overall OCT rates increased over time (p < 0.0001), with variation in rates between centers (p = 0.002). The mean stent length was shortest in the angiography-guided group, longer in the IVUS-guided group, and longest in the OCT-guided group. OCT-guided procedures were associated with greater procedural success rates and reduced in-hospital MACE rates. A significant difference in mortality was observed between patients who underwent OCT-guided PCI (7.7%) compared with patients who underwent either IVUS-guided (12.2%) or angiography-guided (15.7%; p < 0.0001) PCI, with differences seen for both elective (p < 0.0001) and acute coronary syndrome subgroups (p = 0.0024). Overall this difference persisted after multivariate Cox analysis (hazard ratio [HR]: 0.48; 95% confidence interval [CI]: 0.26 to 0.81; p = 0.001) and propensity matching (hazard ratio: 0.39; 95% CI: 0.21 to 0.77; p = 0.0008; OCT vs. angiography-alone cohort), with no difference in matched OCT and IVUS cohorts (HR: 0.88; 95% CI: 0.61 to 1.38; p = 0.43).Conclusions
In this large observational study, OCT-guided PCI was associated with improved procedural outcomes, in-hospital events, and long-term survival compared with standard angiography-guided PCI. 相似文献15.
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《Cardiovascular Revascularization Medicine》2019,20(6):480-484
ObjectiveThis study of patients treated with novolimus-eluting bioresorbable scaffold (BRS) investigated the impact of plaque burden on the acute mechanical performance of the BRS and the short-term outcome.MethodsA total of 15 patients were enrolled. The following parameters were derived from optical coherence tomography (OCT) during the final pullback: mean and minimum area, residual area stenosis, incomplete strut apposition, tissue prolapse, scaffold expansion index (SEI), scaffold eccentricity index (SEC), symmetry index, strut fracture, and edge dissection. Fibrous plaque (FP) and calcific plaque (CP) characteristics were measured at each 200 μm longitudinal cross-section. The patients were divided into two groups based on their medians of the respective plaque characteristics.ResultsOCT analysis showed a lumen area of 11.4 ± 1.9 mm2 and a scaffold area of 11.5 ± 2.1 mm2. The mean eccentricity index overall was 0.65 ± 0.16 and mean symmetry index 0.39 ± 0.25. Statistically, scaffold expansion was not significantly influenced by a greater plaque burden as represented by greater CP area (SEI in group with CP area <0.52 mm2 84.1% vs. SEI of 86.6% in group with CP area ≥0.52 mm2, p = 0.06), thicker CP (85.7% vs. 85.1%, p = 0.06), greater CP arc angle (88.0% vs. 81.7%, p = 0.08), and CP being closer to the lumen (84.2% vs. 86.5%, p = 0.08). Scaffold expansion was also not significantly influenced by FP burden. The eccentricity of the implanted scaffolds was not dependent on the CP burden. On the other hand, a greater FP burden favoured a lower eccentricity index, indicating less circular expansion. Thus, greater FP area, FP thickness, and FP arc angle resulted in a more eccentric scaffold expansion.ConclusionIn contrast to previously studied BRS, the expansion and eccentricity characteristics of the novolimus-eluting scaffold did not show the strong dependency of plaque composition, morphology, and burden. As assessed by OCT, only eccentricity was significantly affected by the FP burden. A greater FP plaque arc in our cohort and device-specific properties, e.g. self-correction, may explain the lack of a relationship between plaque, expansion, and eccentricity. 相似文献
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Michael Joner Tobias Koppara Robert A. Byrne Maria Isabel Castellanos Jonas Lewerich Julia Novotny Giulio Guagliumi Erion Xhepa Tom Adriaenssens Thea C. Godschalk Nikesh Malik Fernando Alfonso Tomohisa Tada Franz-Josef Neumann Walter Desmet Jurrien M. ten Berg Anthony H. Gershlick Laurent J. Feldman Adnan Kastrati 《JACC: Cardiovascular Interventions》2018,11(14):1340-1350