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Residual atherothrombotic burden after primary percutaneous coronary intervention and myocardial reperfusion—An optical frequency domain imaging study
Author(s) -
Roule Vincent,
Schwob Lin,
Lemaitre Adrien,
Big Mathieu,
Ardouin Pierre,
Sabatier Rémi,
Blanchart Katrien,
Beygui Farzin
Publication year - 2020
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.28429
Subject(s) - medicine , conventional pci , percutaneous coronary intervention , cardiology , myocardial infarction , ticagrelor , aspirin , thrombus
Objectives We aimed to assess the relationship between residual in‐stent atherothrombotic burden (ATB) after primary percutaneous coronary intervention (PCI) measured by optical frequency domain imaging (OFDI) using different measurement methods and myocardial blush grade (MBG). Background The impact of residual ATB after primary PCI on myocardial reperfusion remains unclear. Methods We prospectively included 60 ST‐elevation myocardial infarction patients pretreated with aspirin and ticagrelor. OFDI volumetric quantification using planimetry (with intervals every frame or every millimeter) and semiquantitative score were used to determine ATB. Patients were divided into two groups according to final MBG 3 or <3. Results The mean ATB was 10.08 ± 5.21%. ATB was lower in patients with final MBG 3 compared to those with impaired MBG, regardless of the measurement method (8.15 ± 5.58 vs. 11.77 ± 4.28%; p = .007 for quantification per frame; 7.8 ± 5.19 vs. 11.07 ± 4.07%; p = .009 for quantification per mm and 11.21 ± 11.75 vs. 22.91 ± 17.35; p = .003 for the semiquantitative thrombus score, respectively). Conclusion Residual post‐stenting ATB remains substantial after primary PCI in STEMI patients, even when pretreated with ticagrelor and aspirin. ATB appears as a significant correlate of suboptimal myocardial reperfusion, a known surrogate of clinical outcome.