The influence between plaque rupture and non-plaque rupture on clinical outcomes in patients with ST-segment elevation myocardial infarction after primary percutaneous coronary intervention: a prospective cohort study

作者：Xing Yang, Junqing Yang, Yoshifumi Kashima, Daisuke Hachinohe, Takuro Sugie, Shenghui Xu, Xiaosheng Guo, Xida Li, Xiangming Hu, Boyu Sun, Sanjana Nagraj, Anastasios Lymperopoulos, Yong Hoon Kim, Shengxian Tu, Haojian Dong · 发表于：Journal of Thoracic Disease · 年份：2024 · DOI：10.21037/jtd-24-1482 · 被引用次数：6 · 研究领域：Coronary Interventions and Diagnostics、Acute Myocardial Infarction Research、Cardiac Imaging and Diagnostics

Background: Coronary atherosclerosis can lead to acute clinical events upon atherosclerotic plaque rupture (PR) or erosion and arterial thrombus formation. Identifying the effect of distinct plaque characteristics on clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI) is critical for clinical therapy. Our goal was to ascertain the correlation between clinical outcome, long-term prognosis, and morphological plaque characteristics in STEMI. Methods: The data used in this prospective cohort research came from a prior multicenter prospective cohort study (ChiCTR1800019923). One hundred and thirteen consecutive STEMI patients were involved in our cohort study. Patients with STEMI who received primary percutaneous coronary intervention (pPCI) within 24 hours of symptom onset were included in the study and divided into two groups according to plaque characteristics derived from intravascular ultrasound (IVUS): a PR group and a non-PR group. The primary outcome was the incidence of no reflow or slow flow, the secondary outcome was major adverse cardiac events (MACEs) at 1-year follow-up. Results: . 6.90%; P=0.86) in the PR group. Conclusions: In comparison to patients with non-PR, PR were not associated with the risk of recurrent myocardial infarction (MI), revascularization, heart failure, or cardiac death at 1-year follow-up, while associated with an increased incidence of no reflow or slow flow during pPCI. This observation would be considered whi...