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
Jincheng Guo1; Jun Chen2; Guozhong Wang1; Zhi Liu3; Dan Niu1; Yongxia Wu1; Jiahui Song1; Jing Gao3; Zhenxing Fan3; Yinghua Zhang3; Jin Si3; Xuebing Zuo3; Ning Shi3; Zupei Miao3; Zhaorun Bai3; Leimin Zhang3; Binyu Liu3; Jing Li3;
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.