Predicting No-reflow Based on Angiographic Features of Lesions in Patients with Acute Myocardial Infarction
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- Hara Masahide
- Internal Medicine 1, School of Medicine, Oita University, Oita, Japan.
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- Saikawa Tetsunori
- Laboratory Medicine, School of Medicine, Oita University Oita, Japan.
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- Tsunematsu Yoshihiro
- Health Insurance Nankai Hospital Oita, Japan.
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- Sakata Toshiie
- Internal Medicine 1, School of Medicine, Oita University, Oita, Japan.
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- Yoshimatsu Hironobu
- Internal Medicine 1, School of Medicine, Oita University, Oita, Japan.
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Objectives: We tried to elucidate angiographical predictors of no-reflow and to determine a preferable recanalization therapy based on the morphology of lesions. Methods: Seventy-six patients were randomly assigned into groups to receive primary angioplasty (n = 41) or intracoronary thrombolysis (n = 35). Based on angiography, occlusive infarct-related lesions were divided into thrombus-rich and hard plaque lesions. The outcome of the two therapies used for each lesion was compared. Results: The incidence of no-reflow was higher in the thrombus-rich than hard plaque lesions (38 percent vs. 0 percent, p = 0.006); the left ventricular ejection fraction in the chronic phase was lower (46 ± 6 percent vs. 55 ± 5 percent, p < 0.001) for primary angioplasty than thrombolysis. No-reflow was not observed in the hard plaque lesions. However, the incidence of additional reperfusion therapy (88 percent vs. 8 percent, p < 0.001) was higher in the patients who underwent thrombolysis rather than primary angioplasty. Conclusions: We suggest that thrombus-rich lesions in primary angioplasty may predict no-reflow in acute myocardial infarction, and thrombolysis prior to angioplasty may be preferable for these lesions. We also suggest that primary angioplasty may be more effective than thrombolysis for hard plaque lesions.
収録刊行物
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- Journal of Atherosclerosis and Thrombosis
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Journal of Atherosclerosis and Thrombosis 12 (6), 315-321, 2005
一般社団法人 日本動脈硬化学会
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詳細情報 詳細情報について
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- CRID
- 1390001204431390464
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- NII論文ID
- 130004444156
- 10018365118
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- NII書誌ID
- AA11018976
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- ISSN
- 18803873
- 13403478
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- 本文言語コード
- en
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- データソース種別
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- JaLC
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- 使用不可