Tissue characterization and phenotype classification in patients presenting with acute myocardial infarction: Insights from the iWonder study

Tissue characterization and phenotype classification in patients presenting with acute myocardial infarction: Insights from the iWonder study

Author Souza, Cristiano F. Autor UNIFESP Google Scholar
Maehara, Akiko Google Scholar
Mintz, Gary S. Google Scholar
Matsumura, Mitsuaki Google Scholar
Alves, Claudia M. R. Autor UNIFESP Google Scholar
Carvalho, Antonio Carlos Autor UNIFESP Google Scholar
Caixeta, Adriano Autor UNIFESP Google Scholar
Abstract ObjectivesWe sought to assess a new modality of radiofrequency intravascular ultrasound (IVUS) called iMAP-IVUS (Boston Scientific, Santa Clara, California) during the evaluation of patients presenting with high-risk acute coronary syndromes. BackgroundThere are limited data on plaque tissue characterization and phenotype classification using iMAP-IVUS. MethodsIn the iWonder study patients presenting with ST-elevation myocardial infarction (STEMI) or non-STEMI underwent three-vessel grayscale IVUS and iMAP-IVUS tissue characterization prior to percutaneous intervention. In total 385 lesions from 100 patients were divided into culprit (n=100) and nonculprit (n=285) lesions. Lesion phenotype was classified as (i) thin-cap fibroatheroma (iMAP-derived TCFA); (ii) thick-cap fibroatheroma; (iii) pathological intimal thickening; (iv) fibrotic plaque; and (v) fibrocalcific plaque. ResultsCulprit lesions had smaller minimum lumen cross-sectional area (MLA) with greater plaque burden compared to non-culprit lesions. Volumetric analysis showed that culprit lesions had longer length and larger vessel and plaque volumes compared to non-culprit lesions. iMAP-IVUS revealed that culprit lesions presented more NC and fibrofatty volume, both at lesion level and at the MLA site (all P<0.001). Any fibroatheroma was more frequently identified in culprit lesions compared with non-culprit lesions (93% vs. 78.9%, P=0.001), anywhere within the lesion 19.0%, P<0.001) as well as at the MLA site (18.0% vs. 9.5%, P=0.07). ConclusionsThree-vessel radiofrequency iMAP-IVUS demonstrated a greater plaque burden and higher prevalence of any fibroatheroma as well as iMAP-derived TCFAs in culprit versus non-culprit lesions in patients presenting with STEMI or non-STEMI undergoing percutaneous coronary intervention. (c) 2017 Wiley Periodicals, Inc.
Keywords intravascular ultrasound
acute myocardial infarction
xmlui.dri2xhtml.METS-1.0.item-coverage Hoboken
Language English
Sponsor Boston Scientific
St. Jude Medical
Volcano Corporation
Date 2017
Published in Catheterization And Cardiovascular Interventions. Hoboken, v. 90, n. 7, p. 1107-1114, 2017.
ISSN 1522-1946 (Sherpa/Romeo, impact factor)
Publisher Wiley
Extent 1107-1114
Origin http://dx.doi.org/10.1002/ccd.26954
Access rights Closed access
Type Article
Web of Science ID WOS:000417651000010
URI https://repositorio.unifesp.br/handle/11600/58098

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