Abstract 3426: Impact of Culprit Plaque Composition on No-Reflow Phenomenon in Patients with Acute Coronary Syndrome: an Intravascular Ultrasound Radiofrequency Analysis
INTRODUCTION: Percutaneous coronary intervention (PCI) is the most common strategy for treating acute coronary syndrome (ACS). No-reflow phenomenon has been shown to be associated with poor functional and clinical outcomes. However, the relationship between plaque morphology and no-reflow phenomenon has not been fully evaluated yet. Recently, intravascular ultrasound radiofrequency (IVUS RF) data has been shown to provide detailed quantitative and qualitative information on coronary plaque composition in vivo. The purpose of our study was to assess the difference of culprit plaque composition between patients with and without no-reflow phenomenon in ACS by IVUS RF data.
METHODS: IVUS RF analyses were performed in culprit plaques of 46 consecutive patients with ACS undergoing PCI. Plaque composition of minimum lumen area sites and entire plaques was assessed. No-reflow phenomenon was defined as decrease in Thrombolysis In Myocardial Infarction (TIMI) flow grade immediately after mechanical dilatation by at least one grade compared with TIMI flow before mechanical dilatation with no evidence of thrombus, spasm, or dissection.
RESULTS: Among 46 patients, no-reflow phenomenon was observed in 9 patients. There was no difference in plaque burden between culprit lesions with and without no-reflow phenomenon. Culprit plaques with no-reflow phenomenon contained significantly higher percentage of the necrotic core component and smaller percentage of the fibrous component than those without no-reflow phenomenon (Table⇓).
CONCLUSIONS: Culprit plaques with no-reflow phenomenon were different from those without no-reflow phenomenon in ACS.