The correlation between lipid volume in the target lesion, measured by integrated backscatter intravascular ultrasound, and post-procedural myocardial infarction in patients with elective stent implantation.
OBJECTIVE
The aim of this study was to perform quantitative analysis of the plaques of target lesions by integrated backscatter intravascular ultrasound (IB-IVUS) and to investigate the association between these data and the risk of post-procedural myocardial injury after stenting.


RESULTS
One hundred and fourteen consecutive patients who received elective stent implantations following IB-IVUS analysis were enrolled. The volume of each plaque component (lipid, fibrous, and calcified) was calculated for the target lesion. Creatine kinase-MB (CK-MB) and troponin-T (TnT) were also evaluated 18 h after procedure. We defined a post-procedural TnT level higher than three times the normal limit as a post-procedural myocardial injury. Lipid, fibrous, and calcified volumes were greater in patients with myocardial injury than in those without myocardial injury. Lipid and fibrous volumes correlated with post-procedural cardiac biomarkers, and the lipid volume fraction (lipid volume/total plaque volume) also correlated with post-procedural TnT and CK-MB. The fibrous volume fraction for plaques was found to be inversely correlated with post-procedural TnT and CK-MB. Hence, lipid volume and volume fraction were concluded to be independent predictors of post-procedural myocardial injury.


CONCLUSIONS
A larger plaque volume and lipid-rich plaque may be indicative of embolic events after stent implantation, resulting in myocardial injury.
Department of Cardiology, Chubu Rosai Hospital, 1-10-6, Komei, Minato-ku, Nagoya 465-8530, Japan. uetani@med.nagoya-u.ac.jp
Tadayuki
T
Uetani
Tetsuya
T
Amano
Hirohiko
H
Ando
Kiminobu
K
Yokoi
Kosuke
K
Arai
Masataka
M
Kato
Nobuyuki
N
Marui
Michio
M
Nanki
Tatsuaki
T
Matsubara
Hideki
H
Ishii
Hideo
H
Izawa
Toyoaki
T
Murohara
D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000379:methods; D015415:Biomarkers / Q000097:blood; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology / Q000628:therapy; D005260:Female; D006801:Humans; D008055:Lipids / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology* / Q000378:metabolism; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects*; D014336:Troponin / Q000097:blood; D018084:Ultrasonography, Interventional / Q000379:methods
D015415:Biomarkers; D008055:Lipids; D014336:Troponin