title: Intense yellow culprit plaque coloration is closely associated with troponin-T elevation and flow complications following elective coronary stenting.
abstract: OBJECTIVE
  The elevation of troponin-T (TnT) and occurrence of transient slow-flow phenomena have been recognized as procedure-related myocardial injuries. Little is known about the characteristics of high-risk plaque resulting in myocardial injury after coronary stenting.
  
  
  METHODS
  The culprit plaques in 42 consecutive patients with stable angina undergoing elective coronary stenting were observed by angioscopy. The plaque color upon angioscopic examination was classified as either intense yellow or not yellow. Slow flow was defined as < TIMI grade 3 flow during the procedure. The TnT levels were measured 8, 16, and 24 hours after stenting, and myocardial injury was defined as TnT ≥ 0.03 ng/mL at any time point.
  
  
  RESULTS
  Twenty-four patients (57%) had intense yellow plaques and myocardial injury occurred in 22 patients (52%). The frequency of intense yellow plaque was significantly higher in the patients with myocardial injury than in those without myocardial injury (91% vs. 20%, p < 0.001). Transient slow flow occurred frequently in patients with myocardial injury than in those without myocardial injury (23% vs. 0%, p = 0.049). All patients with transient slow flow had intense yellow plaques at the culprit lesions.
  
  
  CONCLUSIONS
  Intense yellow culprit plaque coloration was closely associated with TnT elevation and flow complications following elective coronary stenting. Angioscopically-observed intense yellow coloration may therefore predict high-risk plaque for peri-procedural myocardial injury.
authors.affiliation: Cardiovascular Center, Chiba-Hokusoh Hospital, Nippon Medical School, Chiba, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Murakami
authors.forename: Masamichi
authors.initials: M
authors.lastname: Takano
authors.forename: Masanori
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Toru
authors.initials: T
authors.lastname: Inami
authors.forename: Shigenobu
authors.initials: S
authors.lastname: Inami
authors.forename: Kentaro
authors.initials: K
authors.lastname: Okamatsu
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Ohba
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Seino
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Mizuno
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000601:surgery*; D050197:Atherosclerosis / Q000473:pathology*; D003116:Color; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow; D015607:Stents; D020107:Troponin T / Q000097:blood*
chemical_list: D020107:Troponin T