Introduction
Methods
Study design and population
Coronary angiography and FD-OCT image acquisition
Image analysis and definitions and study endpoints
Statistical analyses
Results
Baseline characteristics and clinical outcomes within initial 2 weeks
Age, years | 63.7 ± 11.7 |
Male gender, n (%) | 44 (85.0) |
Height, cm | 165.6 ± 9.3 |
Body weight, kg | 64.3 ± 12.7 |
Diabetes, n (%) | 22 (42.3) |
Hypertension, n (%) | 32 (61.5) |
Dyslipidemia, n (%) | 42 (80.8) |
eGFR < 60, n (%) | 11 (21.1) |
Smoking, n (%) | 26 (50.0) |
Family history, n (%) | 9 (17.3) |
Culprit vessel, n (%) | |
LAD, RCA, LCx | 21 (40.4), 21 (40.4), 10 (19.2) |
Angiographic reference diameter, mm | 2.78 ± 0.56 |
Diameter stenosis, % | 100 (1–100) |
TIMI-flow, n (%) | |
3, 2, 1, 0 | 1 (1.9), 11 (21.2), 6 (11.5), 34 (65.4) |
Bifurcated lesions, n (%) | 23 (44.2) |
AHA/ACC lesion type, n (%) | |
A, B1, B2, C | 0 (0), 2 (3.8), 39 (75.0), 11 (21.2) |
Door to balloon time, min | 64 (29–276) |
Used stent number, n | 1.15 ± 0.36 |
Used stent diameter, mm | 3.02 ± 0.39 |
Final maximum inflation pressure, atm | 15.0 ± 3.4 |
Aspiration catheter uses, n (%) | 42 (80.8) |
Peak CPK, mg/dl | 1351 (109–7526) |
Peak CPK-MB, mg/dl | 105 (4–445) |
Hemoglobin, mg/dl | 14.3 ± 1.8 |
Chronic antiplatelet use prior to STEMI, n (%) | |
Aspirin, clopidogrel, prasugrel | 2 (3.8), 0 (0%), 0 (0) |
Dual antiplatelet therapy at 2 weeks, n (%) | 52 (100) |
Thienopyridine use, n (%) | |
Clopidogrel, prasugrel | 51 (98.1), 1 (1.9) |
Anticoagulation drugs use | 3 (6.5) |
Qualitative and quantitative coronary angiography
Post-procedure | 2-week follow-up | p value | |
---|---|---|---|
TIMI grade, n (%) | |||
3, 2, 1, 0 | 46 (88.5), 5 (8.6), 1 (2.0), 0 (0) | 41 (80.4), 10 (19.6), 0 (0), 0 (0) | 0.238 |
In-lesion | |||
Reference diameter, mm | 2.88 ± 0.53 | 2.78 ± 0.52 | 0.037 |
MLD, mm | 2.23 ± 0.55 | 2.14 ± 0.59 | 0.129 |
% Diameter stenosis, % | 22.7 ± 11.1 | 23.8 ± 11.8 | 0.552 |
In-stent | |||
Reference diameter, mm | 2.93 ± 0.49 | 2.89 ± 0.48 | 0.095 |
MLD, mm | 2.53 ± 0.46 | 2.49 ± 0.42 | 0.461 |
% DS, % | 13.8 ± 9.8 | 13.5 ± 9.4 | 0.860 |
Stent length, mm | 20.1 ± 6.6 | 20.0 ± 6.6 | 0.582 |
Proximal margin | |||
MLD, mm | 2.75 ± 0.58 | 2.68 ± 0.54 | 0.202 |
% DS, % | 11.8 ± 8.6 | 11.8 ± 8.6 | 0.867 |
Distal margin | |||
MLD, mm | 2.26 ± 0.59 | 2.17 ± 0.58 | 0.118 |
% DS, % | 16.1 ± 11.5 | 17.9 ± 13.3 | 0.244 |
Overall FD-OCT analyses
Variables | Post-procedure (n = 45) | 2 weeks follow-up (n = 49) |
---|---|---|
Visual assessments | ||
No. of cross-section, n | 24.4 ± 7.4 | 24.7 ± 7.4 |
No. of struts, n | 219 ± 76 | 230 ± 75 |
No of malapposed struts, n | 15.9 ± 21.7 | 11.1 ± 15.1 |
% Malapposed struts, % | 7.2 ± 9.0 | 4.7 ± 5.7 |
No. of uncovered struts, n | 143 ± 68 | 49 ± 38 |
% uncovered struts, % | 64.0 ± 19.7 | 20.7 ± 13.7 |
Quantitative measurements | ||
Average stent length, mm | 23.2 ± 7.5 | 23.2 ± 7.4 |
Average stent area, mm2 | 6.65 ± 1.82 | 6.74 ± 1.92 |
Minimum stent area, mm2 | 5.36 ± 1.47 | 5.41 ± 1.62 |
Maximum stent area, mm2 | 8.07 ± 2.57 | 8.12 ± 2.67 |
Average stent diameter, mm | 2.87 ± 0.40 | 2.89 ± 0.42 |
Average lumen area, mm2 | 6.50 ± 1.80 | 6.72 ± 1.90 |
Minimum lumen area, mm2 | 4.97 ± 1.54 | 5.21 ± 1.58 |
Maximum lumen area, mm2 | 8.40 ± 2.58 | 8.53 ± 2.67 |
Average lumen diameter, mm | 2.83 ± 0.40 | 2.88 ± 0.41 |
Average intra-stent tissue area, mm2 | 0.33 ± 0.41 | 0.21 ± 0.18 |
Average intra-stent tissue thickness, mm | 0.031 ± 0.038 | 0.038 ± 0.015 |
Minimum intra-stent tissue thickness, mm | 0 | 0 |
Maximum intra-stent tissue thickness, mm | 0.39 ± 0.29 | 0.28 ± 0.16 |
In-depth serial FD-OCT assessments
Variables | Post-procedure | 2-week follow-up | p value |
---|---|---|---|
No. of cross-section, n | 24.5 ± 7.5 | 24.6 ± 7.5 | 0.41 |
No. of struts, n | 220 ± 76 | 227 ± 75 | 0.03 |
% Malapposed struts, % | 7.3 ± 9.0 | 4.7 ± 5.9 | 0.005 |
% Uncovered struts, % | 63 ± 20 | 21 ± 14 | < 0.0001 |
Average stent length, mm | 23.3 ± 7.5 | 23.2 ± 7.5 | 0.68 |
Average lumen area, mm2 | 6.49 ± 1.82 | 6.71 ± 1.89 | 0.048 |
Minimum lumen area, mm2 | 4.96 ± 1.56 | 5.27 ± 1.56 | 0.040 |
Average intra-stent tissue area, mm2 | 0.34 ± 0.42 | 0.21 ± 0.19 | 0.016 |
% intra-stent tissue area, % | 4.9 ± 6.0 | 3.1 ± 2.5 | 0.024 |
Average intra-stent tissue thickness, mm | 0.031 ± 0.038 | 0.038 ± 0.016 | 0.18 |
Maximum intra-stent tissue thickness, mm | 0.39 ± 030 | 0.28 ± 0.17 | 0.015 |
Serial comparison of in-stent findings | |||
Thrombus | |||
Presence of thrombus, n (%) | 43 (98) | 37 (84) | 0.029 |
No. of thrombus mass (≥ 250 μm), n | 2.9 ± 1.7 | 1.7 ± 1.6 | 0.0001 |
Total longitudinal length, mm | 6.73 ± 5.60 | 4.32 ± 5.02 | 0.0001 |
% Longitudinal length to stent, % | 28.8 ± 22.7 | 18.1 ± 20.2 | 0.0001 |
Maximum area, mm2 | 0.93 ± 0.87 | 0.65 ± 0.63 | 0.034 |
Average maximum height of each mass, mm | 0.49 ± 0.21 | 0.37 ± 0.27 | 0.0036 |
Prolapse | |||
No. of prolapse (≥ 250 μm), n | 0.95 ± 1.0 | 0.52 ± 0.82 | 0.0116 |
Total longitudinal length, mm | 1.36 ± 1.65 | 0.80 ± 1.59 | 0.0558 |
% Longitudinal length to stent, % | 6.0 ± 7.1 | 3.9 ± 7.5 | 0.10 |
Maximum area, mm2 | 0.22 ± 0.25 | 0.11 ± 0.22 | 0.0245 |
Average maximum height of each prolapse, mm | 0.20 ± 0.19 | 0.13 ± 0.22 | 0.1193 |
Malapposition | |||
No. of malapposed segment, n | 2.3 ± 2.1 | 2.3 ± 2.0 | 0.85 |
Total longitudinal length, mm | 3.94 ± 4.42 | 4.30 ± 5.48 | 0.50 |
% Longitudinal length to stent, % | 16.5 ± 15.6 | 17.4 ± 18.8 | 0.629 |
Maximum area, mm2 | 0.72 ± 0.72 | 0.73 ± 0.73 | 0.870 |
Average maximum area of each segment, mm2 | 0.56 ± 0.60 | 0.52 ± 0.46 | 0.565 |
Average maximum depth of each segment, mm | 0.25 ± 0.13 | 0.28 ± 0.16 | 0.277 |
Dissection | |||
No. of dissections (flap ≥ 200 μm), n | 0.86 ± 1.11 | 0.52 ± 0.90 | 0.024 |
Total longitudinal length, mm | 0.73 ± 1.12 | 0.58 ± 1.17 | 0.310 |
% Longitudinal length to stent, % | 3.0 ± 7.0 | 2.3 ± 4.4 | 0.368 |
Transverse length of flap arm, mm | 0.22 ± 0.24 | 0.16 ± 0.25 | 0.251 |
Proximal edge dissectiona, n (%) | 3.0 (6.8) | 0 (0) | 0.121 |
Distal edge dissectionb, n (%) | 3.0 (7.3) | 3.0 (6.2) | 0.63 |