Impact of optical coherence tomography findings on clinical outcomes in ST-segment elevation myocardial infarction patie
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ORIGINAL PAPER
Impact of optical coherence tomography findings on clinical outcomes in ST‑segment elevation myocardial infarction patients: a MATRIX (Minimizing Adverse Hemorrhagic Events by Trans‑radial Access Site and angioX) OCT sub‑study Omar Yacob1 · Hector M. Garcia‑Garcia1 · Kazuhiro Dan1 · Mohamad Soud2 · Marianna Adamo3 · Andrea Picchi4 · Gennaro Sardella5 · Enrico Frigoli6 · Ugo Limbruno4 · Stefano Rigattieri7 · Roberto Diletti8 · Giacomo Boccuzzi9 · Marco Zimarino10 · Marco Contarini11 · Filippo Russo12 · Paolo Calabro13 · Giuseppe Ando14 · Ferdinando Varbella15 · Stefano Garducci16 · Cataldo Palmieri17 · Carlo Briguori18 · Kayode O. Kuku1 · Alexios Karagiannis6 · Marco Valgimigli19 Received: 9 July 2020 / Accepted: 2 November 2020 © Springer Nature B.V. 2020
Abstract Purpose To investigate the association of the degree of stent expansion, as assessed by optical coherence tomography (OCT), following stent implantation, and clinical outcomes in ST-segment elevation myocardial infarction (STEMI) patients. Methods STEMI patients from the MATRIX (Minimizing Adverse Haemorrhagic Events by TRansradial Access Site and angioX) OCT study were selected; Clinical outcomes were collected through 1 year. Stent expansion index is a minimum stent area (MSA) divided by average lumen area (average of proximal and distal reference lumen area). The following variables were measured: MSA ( 200 µm in width and 200 µm distance of stent from vessel wall), a thrombus (area > 5% of lumen area) were compared. Results A total of 151 patients were included; after excluding patients with suboptimal OCT quality, the population with available OCT was classified into 2 groups: under–expanded 80% of the average lumen area which allowed a predicted FFR of > 0.90. Using the reference segment lumen diameters as a map for stent sizing the OPINION trial [19] endorsed it and normal appearing cross sections close to the target lesion, with no lipid plaque, were set as proximal and distal reference sites. Considering this data, it was reasonable in our present study to set an
The International Journal of Cardiovascular Imaging Table 2 Procedural characteristics Procedural characteristics Number of patients Treated vessel(s) per patient Left main coronary artery (%) Left anterior descending artery (%) Left circumflex artery (%) Right coronary artery (%) Lesions treated per patient (interquartile range) One lesion (%) Two lesions (%) Three or more lesions (%) At least one complex lesion (%) Median number of stents per patient (interquartile range) Overall stent length per patient (mm) Lesions Number of lesions with PCI Lesions stented (%) At least one drug–eluting stent (%) At least one bare–metal stent (%) Lesions not stented (%) TIMI flow pre-procedure 0 or 1 (%) 2 (%) 3 (%) TIMI flow post-procedure 0 or 1 (%) 2 (%) 3 (%) Number of lesions stented Total stent length per lesion (mm) Average stent diameter per lesion (mm) At least one direct stenting (%) Post dilatation (%)
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