title: Association of Intravascular Ultrasound- and Optical Coherence Tomography-Assessed Coronary Plaque Morphology With Periprocedural Myocardial Injury in Patients With Stable Angina Pectoris.
abstract: BACKGROUND
  Periprocedural myocardial injury (PMI) is not an uncommon complication and is related to adverse cardiac events after percutaneous coronary intervention (PCI). We investigated the predictors of PMI in patients with stable angina pectoris (SAP) on intravascular imaging.
  
  
  RESULTS
  We enrolled 193 SAP patients who underwent pre-PCI intravascular ultrasound (IVUS) and optical coherence tomography (OCT). Clinical characteristics, lesion morphology, and long-term follow-up data were compared between patients with and without PMI, defined as post-PCI elevation of high-sensitivity cardiac troponin-T. PMI were observed in 79 patients (40.9%). Estimated glomerular filtration rate (odds ratio [OR], 0.973; 95% confidence interval [CI]: 0.950-0.996; P=0.020), ≥2 stents (OR, 3.100; 95% CI: 1.334-7.205; P=0.009), final myocardial blush grade 0-2 (OR, 4.077; 95% CI: 1.295-12.839; P=0.016), and IVUS-identified echo-attenuated plaque (EA; OR, 3.623; 95% CI: 1.700-7.721; P<0.001) and OCT-derived thin-cap fibroatheroma (OCT-TCFA; OR, 3.406; 95% CI: 1.307-8.872; P=0.012) were independent predictors of PMI on multivariate logistic regression analysis. A combination of EA and OCT-TCFA had an 82.4% positive predictive value for PMI. On Cox proportional hazards analysis, PMI was an independent predictor of adverse cardiac events during 1-year follow-up (hazard ratio, 2.984; 95% CI: 1.209-7.361; P=0.018).
  
  
  CONCLUSIONS
  Plaque morphology assessment using pre-PCI IVUS and OCT may be useful for predicting PMI in SAP patients.
authors.affiliation: Cardiovascular Center, Yokosuka Kyosai Hospital.
authors.forename: Shigeki
authors.initials: S
authors.lastname: Kimura
authors.forename: Tomoyo
authors.initials: T
authors.lastname: Sugiyama
authors.forename: Keiichi
authors.initials: K
authors.lastname: Hishikari
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Yamakami
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Sagawa
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kojima
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Ohtani
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Hikita
authors.forename: Atsushi
authors.initials: A
authors.lastname: Takahashi
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Isobe
mesh_terms: D000368:Aged; D060050:Angina, Stable / Q000473:pathology*; D003324:Coronary Artery Disease / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006335:Heart Injuries / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium; D058226:Plaque, Atherosclerotic / Q000473:pathology*; D041623:Tomography, Optical Coherence / Q000009:adverse effects*; D018084:Ultrasonography, Interventional / Q000009:adverse effects*