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ȣ - 550572 398 |
Impact of tissue prolapse after stent implantation on short- and long-term clinical outcomes in patients with acute myocardial infarction: an intravascular ultrasound analysis |
1전남대학교병원 순환기내과, 2광주기독병원 순환기내과 |
홍영준1, 정명호1, 최윤하1, 송진아1, 김동한1, 이기홍1, Futoshi Yamanaka1, 이민구1, 박근호1, 심두선1, 윤남식1, 윤현주1, 김계훈1, 박형욱1, 김주한1, 안영근1, 조정관1, 박종춘1, 이승욱2, 강동구2, 조상기2, 강정채1 |
Background: We used intravascular ultrasound (IVUS) to evaluate the association of tissue prolapse (TP) with short- and long-term clinical outcomes after stent implantation in 418 acute myocardial infarction (AMI) patients (155 ST segment elevation and 263 non-ST segment elevation MI).
Methods: We evaluated the incidences of stent thrombosis, no-reflow, and long-term clinical outcomes.
Results: After stenting, TP was detected in 34% without difference according to the stent types. Acute and subacute stent thrombosis occurred more frequently in patients with TP compared with those without TP (3.5% vs. 0.7%, p=0.035, and 4.2% vs. 0.7%, p=0.013, respectively). No-reflow was developed more frequently in patients with TP compared with those without TP (25.4% vs. 9.8%, p<0.001). Creatine kinase-MB and cardiac-specific troponin I were elevated more significantly after stenting in patients with TP compared with those without TP (=+9.0±25.2 U/l vs. -4.2±41.6 U/l, p=0.001 and =+10.0±43.5 ng/ml vs. -1.2±35.6 ng/ml, p=0.005, respectively). There were no significant differences in the incidences of cardiac death, MI, and target vessel revascularization at 1-year. Multivariate analysis showed that TP was the independent predictor of composite of acute and subacute stent thrombosis [odds ratio (OR)=4.211; 95% CI 1.198-14.805, p=0.025] and composite of acute stent thrombosis and no-reflow (OR=2.551; 95% CI 1.315-4.952, p=0.006).
Conclusions: TP was associated with short-term complications (acute and subacute thrombosis and no-reflow phenomenon), however it was not affect long-term clinical outcomes after stent implantation in patients with AMI.
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