PMID- 23328566
OWN - NLM
STAT- MEDLINE
DCOM- 20130702
LR  - 20161125
IS  - 1876-7591 (Electronic)
IS  - 1876-7591 (Linking)
VI  - 6
IP  - 1
DP  - 2013 Jan
TI  - Dynamic nature of nonculprit coronary artery lesion morphology in STEMI: a serial 
      IVUS analysis from the HORIZONS-AMI trial.
PG  - 86-95
LID - S1936-878X(12)00875-3 [pii]
LID - 10.1016/j.jcmg.2012.08.010 [doi]
AB  - OBJECTIVES: The authors sought to report the temporal stability of an untreated, 
      nonculprit lesion phenotype in patients presenting with ST-segment elevation 
      myocardial infarction (STEMI). BACKGROUND: The temporal stability of the 
      untreated, nonculprit lesion phenotype has been studied using intravascular 
      ultrasound-virtual histology (IVUS) in patients with stable ischemic heart 
      disease, but not in STEMI patients. METHODS: As part of a formal substudy of the 
      HORIZONS-AMI (Harmonizing Outcomes With Revascularization and Stents in Acute 
      Myocardial Infarction) trial, baseline and 13-month follow-up IVUS was performed 
      in 99 untreated nonculprit lesions in 63 STEMI patients. Lesions were classified 
      as pathological intimal thickening (PIT), IVUS-derived thin-cap fibroatheroma 
      (TCFA), thick-cap fibroatheroma (ThCFA), fibrotic plaque, or fibrocalcific 
      plaque. RESULTS: The frequency of TCFA increased from 41% at baseline to 54% at 
      follow-up, whereas ThCFAs decreased from 41% to 34% and PIT decreased from 16% to 
      8%. Among the 41 lesions classified at baseline as TCFA, at follow-up, 32 (78%) 
      were still classified as TCFA, whereas 9 (22%) were classified as ThCFAs or 
      fibrotic plaques. An additional 21 lesions at follow-up were newly classified as 
      TCFA, developing from either PIT or ThCFA. TCFA at baseline that evolved into 
      non-TCFAs trended toward a more distal location than TCFA that did not change (p 
      = 0.12). In lesions classified as TCFA, the minimum lumen area (MLA) decreased 
      from 8.1 (interquartile range [IQR]: 7.4 to 8.8) mm(2) at baseline to 7.8 (IQR: 
      7.2 to 8.4) mm(2) at follow-up, p < 0.05; this was associated with an increase in 
      percent necrotic core at the MLA site (14% [IQR: 12 to 16] to 19% [IQR: 17 to 
      22], p < 0.0001) and over the entire length of the lesion (14% [IQR: 12 to 16] to 
      18% [IQR: 17 to 20], p < 0.0001). CONCLUSIONS: Untreated nonculprit lesions in 
      STEMI patients frequently have TCFA morphology that does not change during 
      13-month follow-up and is accompanied by a decrease in MLA and an increase in 
      necrotic core. (Harmonizing Outcomes With Revascularization and Stents in Acute 
      Myocardial Infarction [HORIZONS-AMI]; NCT00433966).
CI  - Copyright (c) 2013 American College of Cardiology Foundation. Published by Elsevier 
      Inc. All rights reserved.
FAU - Zhao, Zhijing
AU  - Zhao Z
AD  - Columbia University Medical Center/The Cardiovascular Research Foundation, New 
      York, New York 10022, USA.
FAU - Witzenbichler, Bernhard
AU  - Witzenbichler B
FAU - Mintz, Gary S
AU  - Mintz GS
FAU - Jaster, Markus
AU  - Jaster M
FAU - Choi, So-Yeon
AU  - Choi SY
FAU - Wu, Xiaofan
AU  - Wu X
FAU - He, Yong
AU  - He Y
FAU - Margolis, M Pauliina
AU  - Margolis MP
FAU - Dressler, Ovidiu
AU  - Dressler O
FAU - Cristea, Ecaterina
AU  - Cristea E
FAU - Parise, Helen
AU  - Parise H
FAU - Mehran, Roxana
AU  - Mehran R
FAU - Stone, Gregg W
AU  - Stone GW
FAU - Maehara, Akiko
AU  - Maehara A
LA  - eng
SI  - ClinicalTrials.gov/NCT00433966
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PL  - United States
TA  - JACC Cardiovasc Imaging
JT  - JACC. Cardiovascular imaging
JID - 101467978
RN  - 0 (Anticoagulants)
RN  - 0 (Platelet Aggregation Inhibitors)
SB  - IM
MH  - Aged
MH  - Anticoagulants/therapeutic use
MH  - Chi-Square Distribution
MH  - Coronary Artery Disease/complications/*diagnostic imaging/pathology/therapy
MH  - Coronary Vessels/*diagnostic imaging/pathology
MH  - Female
MH  - Fibrosis
MH  - Humans
MH  - Least-Squares Analysis
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*diagnostic imaging/etiology/pathology/therapy
MH  - Myocardial Revascularization/instrumentation
MH  - Necrosis
MH  - Plaque, Atherosclerotic
MH  - Platelet Aggregation Inhibitors/therapeutic use
MH  - Predictive Value of Tests
MH  - Stents
MH  - Time Factors
MH  - Treatment Outcome
MH  - *Ultrasonography, Interventional
EDAT- 2013/01/19 06:00
MHDA- 2013/07/03 06:00
CRDT- 2013/01/19 06:00
PHST- 2012/02/24 00:00 [received]
PHST- 2012/08/13 00:00 [revised]
PHST- 2012/08/21 00:00 [accepted]
PHST- 2013/01/19 06:00 [entrez]
PHST- 2013/01/19 06:00 [pubmed]
PHST- 2013/07/03 06:00 [medline]
AID - S1936-878X(12)00875-3 [pii]
AID - 10.1016/j.jcmg.2012.08.010 [doi]
PST - ppublish
SO  - JACC Cardiovasc Imaging. 2013 Jan;6(1):86-95. doi: 10.1016/j.jcmg.2012.08.010.