CBS 2019
CBSMD教育中心
English

科学研究

科研文章

荐读文献

3D Printing and Heart Failure: The Present and the Future Tissue characterisation of atherosclerotic plaque in the left main: an in vivo intravascular ultrasound radiofrequency data analysis Poor R-wave progression as a predictor of sudden cardiac death in general population and subjects with coronary artery disease 2016 ACC/AHA guideline focused update on duration of dual antiplatelet therapy in patients with coronary artery disease: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines SGLT-2 Inhibitors and Cardiovascular Risk: An Analysis of CVD-REAL A pragmatic approach to the use of inotropes for the management of acute and advanced heart failure: An expert panel consensus Evaluation and Management of Right-Sided Heart Failure: A Scientific Statement From the American Heart Association The Hospital Readmissions Reduction Program Nationwide Perspectives and Recommendations: A JACC: Heart Failure Position Paper A randomized controlled trial to evaluate the safety and efficacy of cardiac contractility modulation in patients with systolic heart failure: rationale, design, and baseline patient characteristics. 中国心力衰竭诊断和治疗指南2018

Original Research2011 Jun;4(3):239-47.

JOURNAL:Circ Cardiovasc Interv. Article Link

Intravascular ultrasound findings of early stent thrombosis after primary percutaneous intervention in acute myocardial infarction: a Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI) substudy

Choi SY, Witzenbichler B, Maehara A et al. Keywords: stents; thrombosis; ultrasonics;myocardial infarction

ABSTRACT


BACKGROUND - Small stent area and residual inflow/outflow disease have been reported as the strongest intravascular ultrasound (IVUS) predictors of early stent thrombosis (ST) in patients with stable angina. IVUS predictors of early ST in patients with acute myocardial infarction have not been studied.


METHODS AND RESULTS - In the Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI) study, a formal substudy included poststent and 13-month follow-up IVUS at 36 centers. Twelve patients with baseline IVUS who had definite/probable early ST ≤30 days after enrollment were compared with 389 patients without early ST. Significant residual stenosis was a lumen area <4.0 mm(2) with ≥70% plaque burden ≤10 mm from each stent edge. Significant edge dissection was more than medial dissection with lumen area <4 mm(2) or dissection angle ≥60°. Randomization to bivalirudin (P=0.29) or paclitaxel-eluting stent (P=0.74) was not related to early ST. Minimum lumen area was smaller in patients with versus without early ST (4.4 mm(2) [3.6, 6.9] versus 6.7 mm(2) [5.3, 8.0], respectively, P=0.014). Minimum lumen area <5 mm(2), significant residual stenosis, significant stent edge dissection, and significant tissue (plaque/thrombus) protrusion (more than the median that narrowed the lumen to <4 mm(2)) were more prevalent in patients with early ST, but significant acute malapposition (more than the median) was not. Overall, 100% of patients with early ST had at least 1 of these significant features: minimum lumen area <5 mm(2), edge dissection, residual stenosis, or tissue protrusion versus 23% in patients without early ST (P<0.01).

CONCLUSIONS - Smaller final lumen area and inflow/outflow disease (residual stenosis or dissection) but not acute malapposition were related to early ST after acute myocardial infarction intervention.

CLINICAL TRIAL REGISTRATION - URL: http://www.clinicaltrials.gov. Unique identifier: NCT00433966.