Impact of Culprit Plaque Composition on the No-Reflow Phenomenon in Patients With Acute Coronary Syndrome An Intravascular Ultrasound Radiofrequency Analysis

Yasutomi Higashikuni; Kengo Tanabe; Shuzou Tanimoto; Jiro Aoki; Hirosada Yamamoto; Gaku Nakazawa; Ruri Chihara; Yoshinobu Onuma; Shuji Ohtsuki; Atsuhiko Yagishita; Sen Yachi; Hiroyoshi Nakajima; Kazuhiro Hara

doi:10.1253/circj.72.1235

Clinical Investigation

Impact of Culprit Plaque Composition on the No-Reflow Phenomenon in Patients With Acute Coronary Syndrome

An Intravascular Ultrasound Radiofrequency Analysis

Yasutomi Higashikuni, Kengo Tanabe, Shuzou Tanimoto, Jiro Aoki, Hirosada Yamamoto, Gaku Nakazawa, Ruri Chihara, Yoshinobu Onuma, Shuji Ohtsuki, Atsuhiko Yagishita, Sen Yachi, Hiroyoshi Nakajima, Kazuhiro Hara

Author information

Yasutomi Higashikuni
Division of Cardiology, Mitsui Memorial Hospital
Kengo Tanabe
Division of Cardiology, Mitsui Memorial Hospital
Shuzou Tanimoto
Division of Cardiology, Mitsui Memorial Hospital
Jiro Aoki
Division of Cardiology, Mitsui Memorial Hospital
Hirosada Yamamoto
Division of Cardiology, Mitsui Memorial Hospital
Gaku Nakazawa
Division of Cardiology, Mitsui Memorial Hospital
Ruri Chihara
Division of Cardiology, Mitsui Memorial Hospital
Yoshinobu Onuma
Division of Cardiology, Mitsui Memorial Hospital
Shuji Ohtsuki
Division of Cardiology, Mitsui Memorial Hospital
Atsuhiko Yagishita
Division of Cardiology, Mitsui Memorial Hospital
Sen Yachi
Division of Cardiology, Mitsui Memorial Hospital
Hiroyoshi Nakajima
Division of Cardiology, Mitsui Memorial Hospital
Kazuhiro Hara
Division of Cardiology, Mitsui Memorial Hospital

Keywords: Coronary artery disease, Intravascular ultrasound, Percutaneous coronary intervention, Plaque

JOURNAL FREE ACCESS

2008 Volume 72 Issue 8 Pages 1235-1241

DOI https://doi.org/10.1253/circj.72.1235

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Abstract

Background The difference in the culprit plaque composition of acute coronary syndrome (ACS) patients with and without the no-reflow phenomenon has not been fully evaluated. Methods and Results Intravascular ultrasound radiofrequency data of culprit plaques were obtained and analyzed in 49 ACS patients. The no-reflow phenomenon was defined as a decrease of at least 1 grade in `Thrombolysis In Myocardial Infarction' flow immediately after mechanical dilatation compared with before mechanical dilatation, with no evidence of thrombus, spasm, or dissection. The no-reflow phenomenon was observed in 9 individuals. Culprit plaques with the no-reflow phenomenon contained a higher percentage of necrotic core component and a smaller percentage of fibrous component than plaques in the patients without the no-reflow phenomenon (necrotic core component, 22.1±9.3% vs 11.7±7.9%, p=0.0011; fibrous component, 59.6±11.2% vs 68.3±10.2%, p=0.027). Multivariate analysis identified the percentage of necrotic core component as an independent predictor of the no-reflow phenomenon after adjustment for plaque geometry and procedural factors (odds ratio, 1.7; 95% confidence interval, 1.1 to 2.5; p=0.015). Conclusion Culprit plaques of patients with the no-reflow phenomenon differ from those in patients without the no-reflow phenomenon. (Circ J 2008; 72: 1235 - 1241)

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