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首页> 外文期刊>JACC. Cardiovascular interventions >The relationship between attenuated plaque identified by intravascular ultrasound and no-reflow after stenting in acute myocardial infarction: the HORIZONS-AMI (Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction) trial.
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The relationship between attenuated plaque identified by intravascular ultrasound and no-reflow after stenting in acute myocardial infarction: the HORIZONS-AMI (Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction) trial.

机译：在急性心肌梗死中通过血管内超声识别的斑块减少与支架置入后无复流之间的关系：HORIZONS-AMI（在急性心肌梗死中协调血运重建和支架的预后）。

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OBJECTIVES: The aim of this study was to understand the impact of attenuated plaque on distal embolization during stent implantation in patients with acute myocardial infarction (AMI). BACKGROUND: Attenuated plaques identified by grayscale intravascular ultrasound (IVUS) might predict transient deterioration in coronary flow and/or no-reflow during percutaneous coronary intervention (PCI). METHODS: We analyzed clinical, angiographic, and IVUS data from 364 patients (n = 364 infarct-related arteries) enrolled in the randomized HORIZONS-AMI (Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction) trial. No-reflow was final Thrombolysis In Myocardial Infarction (TIMI) flow grade /=2 points (90 degrees to 180 degrees , sensitivity of 81.5%, and specificity of 80.5%). CONCLUSIONS: Attenuated plaque was present in three-quarters of patients with AMI. The amount of attenuated plaque strongly correlated with no-reflow; the larger the attenuated plaque, the greater the likelihood of no-reflow. (Dual Arm Factorial Randomized Trial in Patients w/ST Segment Elevation AMI to Compare the Results of Using Anticoagulation With Either Unfractionated Heparin + Routine GP IIb/IIIa Inhibition or Bivalirudin + Bail-out GP IIb/IIIa Inhibition; and Primary Angioplasty with stent implantation with Either a Slow Rate-release Paclitaxel-eluting Stent [TAXUS] or Uncoated Bare Metal Stent [EXPRESS2]; NCT00433966).
机译：目的：本研究的目的是了解急性心肌梗死（AMI）患者在支架植入过程中衰减斑块对远端栓塞的影响。背景：通过灰阶血管内超声（IVUS）识别的斑块减少可能预示了经皮冠状动脉介入治疗（PCI）期间冠状动脉血流的短暂恶化和/或无复流。方法：我们分析了参加随机HORIZONS-AMI（协调急性心肌梗死的血运重建和支架结局）试验的364例患者（n = 364个梗死相关动脉）的临床，血管造影和IVUS数据。在没有机械性阻塞的情况下，最终无溶栓是心肌梗死（TIMI）血流级别 / = 2分（90度至180度，灵敏度为81.5％，特异性为80.5％）。结论：四分之三的AMI患者存在斑块减弱。衰减斑块的数量与无回流密切相关;衰减斑块越大，不回流的可能性越大。 （具有ST段抬高AMI的患者进行的双重手臂因子随机试验，比较使用抗凝结合普通肝素+常规GP IIb / IIIa抑制或比伐卢定+纾困GP IIb / IIIa抑制的结果;以及原发性血管成形术和支架植入使用慢速释放紫杉醇洗脱支架[TAXUS]或未涂覆的裸金属支架[EXPRESS2]; NCT00433966）。

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