PMID- 32197256
OWN - NLM
STAT- MEDLINE
DCOM- 20210407
LR  - 20210924
IS  - 1361-6579 (Electronic)
IS  - 0967-3334 (Linking)
VI  - 41
IP  - 4
DP  - 2020 May 7
TI  - Reflectance spectral analysis for novel characterization and clinical assessment 
      of aspirated coronary thrombi in patients with ST elevation myocardial 
      infarction.
PG  - 045001
LID - 10.1088/1361-6579/ab81de [doi]
AB  - OBJECTIVE: The visual appearance of coronary thrombi may be clinically 
      informative in ST elevation myocardial infarction (STEMI) patients undergoing 
      primary percutaneous coronary intervention (pPCI). However, subjective assessment 
      is poorly reproducible and cannot provide an objective basis for treatment 
      decisions or patient stratification. We have assessed the feasibility of a novel 
      reflectance spectroscopy technique to systematically characterize coronary artery 
      thrombi retrieved by aspiration during pPCI in patients with STEMI, and the 
      clinical utility for predicting distal microvascular obstruction. APPROACH: 
      Patients with STEMI treated with pPCI and thrombus aspiration (n = 288) were 
      recruited from the Oxford Acute Myocardial Infarction (OxAMI) Study. Of these, 
      158 patients underwent cardiac magnetic resonance imaging within 48 h for 
      assessment of microvascular obstruction (MVO). Coronary thrombi were imaged by 
      reflectance spectroscopy across wavelengths 500-800 nm. MAIN RESULTS: Spectral 
      data were analysed using function fitting and multivariate models. The 
      coefficient 'c (red)' determined from the fitting procedure correlated with the 
      visually-assessed colour of thrombi ('red' or 'white') and with MVO. When applied 
      to a reduced data set, consisting of spectra from 20 patients with the largest 
      MVO and from 20 propensity-score-matched patients with no MVO, three multivariate 
      analysis methods were able to discriminate spectra of thrombi from patients 
      without MVO and with the largest MVO. SIGNIFICANCE: Reflectance spectral analysis 
      of coronary thrombus provides new insights into the pathology of STEMI, with 
      potential clinical implications for emergency patient care. Further studies are 
      warranted for validation as a point-of-care stratification tool in predicting the 
      degree of microvascular injury and clinical outcomes in STEMI.
FAU - De Maria, Giovanni Luigi
AU  - De Maria GL
AD  - Oxford Heart Centre, NIHR Biomedical Research Centre, Oxford University 
      Hospitals, John Radcliffe Hospital, Oxford, United Kingdom.
FAU - Lee, Regent
AU  - Lee R
FAU - Alkhalil, Mohammad
AU  - Alkhalil M
FAU - Borlotti, Alessandra
AU  - Borlotti A
FAU - Kotronias, Rafail
AU  - Kotronias R
FAU - Langrish, Jeremy
AU  - Langrish J
FAU - Lucking, Andrew
AU  - Lucking A
FAU - Dawkins, Sam
AU  - Dawkins S
FAU - Choudhury, Robin P
AU  - Choudhury RP
FAU - Kharbanda, Rajesh
AU  - Kharbanda R
FAU - Banning, Adrian P
AU  - Banning AP
FAU - Vallance, Claire
AU  - Vallance C
FAU - Channon, Keith M
AU  - Channon KM
LA  - eng
GR  - CH/16/1/32013/BHF_/British Heart Foundation/United Kingdom
PT  - Journal Article
DEP - 20200507
PL  - England
TA  - Physiol Meas
JT  - Physiological measurement
JID - 9306921
SB  - IM
MH  - Feasibility Studies
MH  - Female
MH  - Humans
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Percutaneous Coronary Intervention
MH  - ST Elevation Myocardial Infarction/*complications/surgery
MH  - Thrombosis/*complications/*diagnosis/diagnostic imaging
EDAT- 2020/03/21 06:00
MHDA- 2021/04/10 06:00
CRDT- 2020/03/21 06:00
PHST- 2020/03/21 06:00 [pubmed]
PHST- 2021/04/10 06:00 [medline]
PHST- 2020/03/21 06:00 [entrez]
AID - 10.1088/1361-6579/ab81de [doi]
PST - epublish
SO  - Physiol Meas. 2020 May 7;41(4):045001. doi: 10.1088/1361-6579/ab81de.