The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

Plaque characteristics in patients with ST-segment elevation myocardial infarction and early spontaneous reperfusion

DOI: 10.4244/EIJ-D-20-00812

1. Department of Cardiology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
2. Xuanwu Hospital, Cardiology, Beijing, China
3. Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, China, China
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Background: Early spontaneous reperfusion (ESR) is not an uncommon phenomenon in clinical settings.

Aims: To detect potential mechanisms of early spontaneous reperfusion in patients with STEMI.

Methods: This prospective study enrolled a total of 241 consecutive patients with STEMI undergoing optical coherence tomography (OCT) from July 2016 to August 2019. Forty-five (18.7%) met angiographic ESR criteria (TIMI-3 flow on the initial angiogram). Among those without ESR (TIMI-0 flow on initial angiogram), 45 patients were assigned into the control group according to propensity score matching with the ESR group.

Results: Although the group’s baseline characteristics were comparable, non-ruptured plaque (62.2% vs 35.6%) predominated and plaque rupture (37.8% vs 64.4%) was less common in the ESR group (P=0.011). Red thrombus (44.4% vs. 77.8%) was also less common in the ESR group (P=0.001). Lastly, compared to the control group, the ESR group underwent fewer emergent stents placements (68.9% vs. 91.1%, P=0.008).

Conclusion: Relief of coronary occlusion induced by a non-ruptured plaque may contribute to early spontaneous reperfusion in patients with STEMI.

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