Coronary interventions

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

EuroIntervention 2021;17:e664-e671. DOI: 10.4244/EIJ-D-20-00812

Jincheng Guo
Jincheng Guo1, MD, PhD; Jun Chen2, MD; Guozhong Wang1, MD; Zhi Liu1, MD, PhD; Dan Niu1, MD; Yongxia Wu1, MD; Jiahui Song1, MD; Jing Gao2, MD, PhD; Zhenxing Fan2, MD, PhD; Yinghua Zhang2, MD; Jin Si2, MD; Xuebing Zuo2, MD; Ning Shi2, MD; Zupei Miao2, MD; Zhaorun Bai2, MD; Leimin Zhang2, MD; Binyu Liu2, MD; Jing Li2,3, MD, PhD
1. Department of Cardiology, Beijing Luhe Hospital, Capital Medical University, Beijing, China; 2. Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, China; 3. National Clinical Research Center for Geriatric Diseases, Beijing, China

Background: Early spontaneous reperfusion (ESR) is not an uncommon phenomenon in clinical settings.

Aims: The aim of this study was to detect potential mechanisms of ESR 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 patients (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 to the control group according to propensity score matching with the ESR group.

Results: Although the baseline characteristics of the groups 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 stent placements (68.9% vs 91.1%, p=0.008).

Conclusions: Relief of coronary occlusion induced by a non-ruptured plaque may contribute to ESR in patients with STEMI.

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optical coherence tomographyplaque rupturestemi
Coronary interventionsSTEMI
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