• Circ Cardiovasc Interv · Sep 2016

    Comparative Study

    Coronary Plaque Characteristics Associated With Reduced TIMI (Thrombolysis in Myocardial Infarction) Flow Grade in Patients With ST-Segment-Elevation Myocardial Infarction: A Combined Optical Coherence Tomography and Intravascular Ultrasound Study.

    • Takumi Higuma, Tsunenari Soeda, Masahiro Yamada, Takashi Yokota, Hiroaki Yokoyama, Fumie Nishizaki, Lei Xing, Erika Yamamoto, Krzysztof Bryniarski, Jiannan Dai, Hang Lee, Ken Okumura, and Ik-Kyung Jang.
    • From the Department of Cardiology, Hirosaki University Graduate School of Medicine, Japan (T.H., M.Y., T.Y., H.Y., F.N., K.O.); Cardiology Division (T.H., T.S., L.X., E.Y., K.B., J.D., I.-K.J.) and Biostatistics Center (H.L.), Massachusetts General Hospital and Harvard Medical School, Boston; and Division of Cardiology, Kyung Hee University, Seoul, Republic of Korea (I.-K.J.).
    • Circ Cardiovasc Interv. 2016 Sep 1; 9 (9).

    BackgroundPrevious studies reported that reduced TIMI (Thrombolysis in Myocardial Infarction) flow grade before procedure was associated with worse clinical outcomes in patients with ST-segment-elevation myocardial infarction undergoing primary percutaneous coronary intervention. The aim of this study was to identify specific morphological characteristics of the culprit plaque associated with poor TIMI flow grade at baseline in patients with ST-segment-elevation myocardial infarction using both optical coherence tomography and intravascular ultrasound.Methods And ResultsA total of 111 ST-segment-elevation myocardial infarction patients who underwent percutaneous coronary intervention within 24 hours of symptom onset were included. Both optical coherence tomography and intravascular ultrasound were performed after thrombectomy. Patients were divided into 2 groups according to preprocedural TIMI flow grade (TIMI 0-1 [n=82] and TIMI 2-3 [n=29]). Patients with preprocedural TIMI 0 to 1 had a greater lipid arc (P=0.037), a longer lipid length (P=0.021), and a greater lipid index (P=0.007) determined by optical coherence tomography and a larger external elastic membrane cross-sectional area (P=0.030) and plaque plus media cross-sectional area (P=0.030) determined by intravascular ultrasound, compared with patients with preprocedural TIMI 2 to 3.ConclusionsST-segment-elevation myocardial infarction patients with reduced TIMI flow grade at baseline have greater lipid burden, larger vessel sizes, and larger plaque areas.© 2016 American Heart Association, Inc.

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