@article{3162217,
    title = "Association of virtual histology characteristics of the culprit plaque
with post-fibrinolysis flow restoration in ST-elevation myocardial
infarction",
    author = "Giannopoulos, Georgios and Pappas, Loukas and Synetos, Andreas and and Hahalis, George and Raisakis, Konstantinos and Papadimitriou, and Charalampos and Kossyvakis, Charalampos and Alexopoulos, Dimitrios and and Tousoulis, Dimitrios and Stefanadis, Christodoulos and Cleman, Michael and W. and Deftereos, Spyridon",
    journal = "International Journal of Cardiology",
    year = "2014",
    volume = "174",
    number = "3",
    pages = "678-682",
    publisher = "Elsevier Ireland Ltd",
    issn = "0167-5273",
    doi = "10.1016/j.ijcard.2014.04.211",
    keywords = "virtual histology; thrombolysis; TIMI flow grade; STEMI; intravascular
ultrasound; radiofrequency backscatter analysis",
    abstract = "Objectives: We sought to test the hypothesis that virtual histology
characteristics of the culprit lesion in patients with ST-elevation
myocardial infarction are associated with blood flow restoration after
thrombolysis.
Methods: Consecutive patients referred for coronary angiography after
successful thrombolysis were included in this correlational
cross-sectional study. Evaluation with intravascular ultrasound (IVUS)
and virtual histology of the culprit arterial segment was performed in
all cases.
Results: Forty-eight patients (60.5 +/- 10.7 years) were included. TIMI
flow grade 3 was found in 24 (50%). Diabetes was strongly associated
with lower TIMI flow 3 rate (26.7% vs 60.6%; p = 0.029) and there was
a significant difference in the time to thrombolysis (2.0 +/- 0.8 hours
in those with TIMI flow 3 vs 3.0 +/- 0.7 hours in TIMI flow grades 1-2;
p < 0.001). Patients with TIMI flow grades 3 and 1-2 had similar
absolute total plaque volume (152.8 +/- 59.3 mm(3) vs 147.5 +/- 92.3
mm(3); p = 0.817) and absolute necrotic core (NC) volume (31.2 +/- 13.9
mm(3) vs 33.6 +/- 23.2 mm(3); p = 0.671). However, there were
significant differences in the relative NC content, both in proportion
to the whole plaque volume (26.3% vs 29.9%; p = 0.016) and as an area
fraction at the largest NC site (31.5% vs 40.3%; p < 0.001).
Conclusion: The NC content of atherosclerotic plaques is meaningful for
flow restoration after the occurrence of a coronary event. This finding
highlights the importance of plaque composition, as studied with virtual
histology, not only for the sequence of processes leading to an acute
plaque-related event, but also for thrombus formation and lysis,
following the occurrence of such an event. (C) 2014 Elsevier Ireland
Ltd. All rights reserved."
}