Open AccessThe randomized study of preventive revascularization of vulnerable coronary artery plaques in patients with stable coronary artery disease
Author(s) -
Н. А. Кочергин,
В. И. Ганюков
Publication year - 2020
Publication title -
kompleksnye problemy serdečno-sosudistyh zabolevanij
Language(s) - English
Resource type - Journals
eISSN - 2587-9537
pISSN - 2306-1278
DOI - 10.17802/2306-1278-2019-8-4s-104-110
Subject(s) - medicine , intravascular ultrasound , revascularization , cardiology , coronary artery disease , stenosis , randomized controlled trial , clinical endpoint , artery , lumen (anatomy) , coronary arteries , fractional flow reserve , radiology , myocardial infarction , coronary angiography
Background. Today, a number of unresolved issues remain regarding vulnerable coronary plaques, one of which is the need for preventive revascularization. Aim. Evaluation of the appropriateness of preventive revascularization of functionally insignificant lesions of the coronary arteries with signs of vulnerability according to the virtual histology of intravascular ultrasound in patients with stable coronary artery disease. Methods. The prospective randomized study includes patients with stable coronary artery disease and isolated intermediate-grade coronary stenosis. The first step in patients is measured fractional flow reserve to confirm the hemodynamic insignificance of stenosis. Then an intravascular ultrasound is performed to verify signs of plaque vulnerability: a thin-cap fibroatheroma and / or minimum lumen area 70%. After that, patients are randomized into two groups: preventive revascularization or optimal medical therapy. After 12 months, patients undergo repeated intravascular ultrasound and end-point analysis. Results. So far, 10 patients have been included in the study (6 in the preventive revascularization group and 4 in the optimal medical therapy group). No endpoints and complications were recorded in both groups in 30-days follow-up. Conclusion. Intravascular imaging methods can identify vulnerable coronary plaques, which allows you to use a personalized approach in determining treatment tactics, one of which can be preventive revascularization.