title: Impact of culprit plaque composition on the no-reflow phenomenon in patients with acute coronary syndrome: an intravascular ultrasound radiofrequency analysis.
abstract: BACKGROUND
  The difference in the culprit plaque composition of acute coronary syndrome (ACS) patients with and without the no-reflow phenomenon has not been fully evaluated.
  
  
  RESULTS
  Intravascular ultrasound radiofrequency data of culprit plaques were obtained and analyzed in 49 ACS patients. The no-reflow phenomenon was defined as a decrease of at least 1 grade in 'Thrombolysis In Myocardial Infarction' flow immediately after mechanical dilatation compared with before mechanical dilatation, with no evidence of thrombus, spasm, or dissection. The no-reflow phenomenon was observed in 9 individuals. Culprit plaques with the no-reflow phenomenon contained a higher percentage of necrotic core component and a smaller percentage of fibrous component than plaques in the patients without the no-reflow phenomenon (necrotic core component, 22.1+/-9.3% vs 11.7+/-7.9%, p=0.0011; fibrous component, 59.6+/-11.2% vs 68.3+/-10.2%, p=0.027). Multivariate analysis identified the percentage of necrotic core component as an independent predictor of the no-reflow phenomenon after adjustment for plaque geometry and procedural factors (odds ratio, 1.7; 95% confidence interval, 1.1 to 2.5; p=0.015).
  
  
  CONCLUSIONS
  Culprit plaques of patients with the no-reflow phenomenon differ from those in patients without the no-reflow phenomenon.
authors.affiliation: Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan.
authors.forename: Yasutomi
authors.initials: Y
authors.lastname: Higashikuni
authors.forename: Kengo
authors.initials: K
authors.lastname: Tanabe
authors.forename: Shuzou
authors.initials: S
authors.lastname: Tanimoto
authors.forename: Jiro
authors.initials: J
authors.lastname: Aoki
authors.forename: Hirosada
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Gaku
authors.initials: G
authors.lastname: Nakazawa
authors.forename: Ruri
authors.initials: R
authors.lastname: Chihara
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Onuma
authors.forename: Shuji
authors.initials: S
authors.lastname: Ohtsuki
authors.forename: Atsuhiko
authors.initials: A
authors.lastname: Yagishita
authors.forename: Sen
authors.initials: S
authors.lastname: Yachi
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Nakajima
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hara
mesh_terms: D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy; D003326:Coronary Circulation; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D054318:No-Reflow Phenomenon / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D016017:Odds Ratio; D018570:Risk Assessment; D012307:Risk Factors; D018084:Ultrasonography, Interventional