Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
Clinical Investigation
Prediction of No-Reflow Phenomenon After Successful Percutaneous Coronary Intervention in Patients With Acute Myocardial Infarction
Intravascular Ultrasound Findings
Tetsuya WatanabeShinsuke NantoMasaaki UematsuTomoki OharaTakakazu MorozumiJun-ichi KotaniMayu NishioMasaki AwataSeiki NagataMasatsugu Hori
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Volume 67 (2003) Issue 8 Pages 667-671

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Abstract

Plaque characterization by intravascular ultrasound (IVUS) before percutaneous coronary intervention (PCI) was evaluated in 81 consecutive patients with acute myocardial infarction (AMI) to establish if IVUS can predict the occurrence of the `no-reflow' phenomenon. Angiographic no-reflow was defined as TIMI flow grade 1 or 2 without any mechanical obstruction in the epicardial artery. Patients were divided into 2 groups according to the post-PCI angiograms: normal flow (group R, n=60) and no-reflow (group NR, n=21). Although the incidence of either soft or noncalcified plaque was not statistically different between the groups, positive vessel remodeling was more frequent in group NR than in group R (57.1% vs 31.6%, p<0.05). Lipid core was also more frequently found in group NR than in group R (61.9% vs 25.0%, p<0.01). Positively remodeled vessels with lipid-rich plaques as characterized by IVUS before PCI predicted the occurrence of angiographic no reflow with a sensitivity of 43% and a specificity of 60%. (Circ J 2003; 67: 667 - 671)

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© 2003 THE JAPANESE CIRCULATION SOCIETY
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