Key result
Vulnerable morphological characteristics of culprit coronary plaques, such as maximum lipid arc (OR 2.03) and lipid plaque (OR 1.48), were significantly associated with poor initial TIMI blood flow before PCI in patients with STEMI.
Why the study?
The study aimed to investigate the relationship between morphological characteristics of culprit coronary plaques and TIMI blood flow grade in patients with STEMI.
Observational (n=222)
No
Morphological characteristics of culprit coronary plaques, including lipid burden and thin-cap fibroatheroma, are significantly associated with poor initial TIMI blood flow before PCI in STEMI patients.
Lipid-rich plaques and TCFA may signal higher risk of impaired flow in STEMI; leaves open whether plaque imaging alters management.
The present study aimed to investigate the relationship between morphological characteristics of culprit coronary plaques and thrombolysis in myocardial infarction (TIMI) blood flow grade in patients with ST-segment elevation myocardial infarction (STEMI). According to the TIMI blood flow of the culprit vessel before percutaneous coronary intervention (PCI), 222 patients with STEMI were divided into two groups: TIMI 0/1 group (n=164) and TIMI 2/3 group (n=58). The baseline characteristics, coronary angiographic findings and optical coherence tomography images were collected. Multivariate logistic regression analysis was used to identify factors independently associated with poor initial TIMI blood flow. Compared with TIMI 2/3 group, TIMI 0/1 group had a significantly smaller minimum lumen diameter, greater diameter stenosis and longer lesion length, a higher incidence of lipid plaque, larger lipid length, maximum lipid arc, lipid index and maximum cross-sectional area (CSA) of plaque rupture, as well as a higher prevalence of thin-cap fibroatheroma (TCFA) and healed plaque (P<0.05). Multivariate logistic analysis demonstrated that lipid plaque, lipid length, maximum lipid arc, lipid index, TCFA, maximum CSA of plaque rupture and healed plaque were significantly associated with poor initial TIMI blood flow (P<0.05). In conclusion, the present study revealed that the morphological characteristics of culprit coronary plaques (lipid plaque, lipid length, maximum lipid arc, lipid index, TCFA, maximum CSA of plaque rupture and healed plaque) are significantly associated with poor initial TIMI blood flow before PCI in patients with STEMI.
No takes yet. Share an insight, caveat, or question.
Song et al. (2023) conducted an observational in ST-segment elevation myocardial infarction (STEMI) (n=222). Vulnerable plaque characteristics (e.g., maximum lipid arc) vs. Absence of vulnerable plaque characteristics was evaluated on Poor initial TIMI blood flow (grade 0/1) (OR 2.03, 95% CI 1.43-2.86, p=0.002). Vulnerable morphological characteristics of culprit coronary plaques, such as maximum lipid arc (OR 2.03) and lipid plaque (OR 1.48), were significantly associated with poor initial TIMI blood flow before PCI in patients with STEMI.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: