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Serial Intravascular Ultrasonic Study of Outcomes of Coronary Culprit Lesions With Plaque Rupture Following Bare Metal Stent Implantation in Patients With Angina Pectoris

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Author(s)
Seung-Ho HurAli H.M. HassanRachna RekhiJunya Ako, Yoshihisa ShimadaMamoo NakamuraMasao YamasakiHeidi N. BonneauKrishnankutty SudhirPaul G. YockYasuhiro HondaPeter J. Fitzgerald
Publication Year
2007
Abstract
Coronary culprit lesions with plaque rupture (PR) have been treated with different coronary
interventions. However, it is unknown whether the presence of PR affects the restenotic
process after coronary intervention. One hundred forty-two patients undergoing
coronary bare metal stent implantation were enrolled in the present retrospective analysis.
Case selection was based on availability of intravascular ultrasound (IVUS) and quantitative
coronary angiographic examinations at baseline (before and after intervention) and
at follow-up. Serial comparative analyses included qualitative and quantitative features of
the culprit lesion and reference segments. PR was defined as an intraplaque cavity in
communication with the lumen in the presence of a residual, disrupted cap. Patients were
categorized according to the presence/absence of PR. Preinterventional IVUS detected PR
in 54 patients (38%). Baseline patient demographics were similar between the PR and
PR groups. Quantitative IVUS analysis showed higher rates of positive remodeling and
larger vessel and plaque areas in the PR compared with PR lesions (p <0.001 for all).
At follow-up (7.2 2.6 months), no statistically significant difference was observed
between the 2 groups in quantitative coronary angiographic or IVUS measurements. In
conclusion, culprit lesions with PR exhibited larger plaque mass and higher rates of positive
remodeling at preintervention IVUS examination. However, when treated with bare metal
stents, the absence/presence of preintervention PR was not found to affect the rate or
severity of in-stent restenosis in these culprit lesions. © 2007 Elsevier Inc. All rights
reserved. (Am J Cardiol 2007;99:1394 –1398)
Department
Dept. of Internal Medicine (내과학)
Publisher
School of Medicine
Citation
American Journal of Cardiology, Vol.99(10) : 1394-1398, 2007
Type
Article
ISSN
0002-9149
DOI
10.1016/j.amjcard.2006.12.067
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/34898
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