Eroded Versus Ruptured Plaques at the Culprit Site of XXXX : In  Vivo Pathophysiological Features and Response to Primary  PCI.

@entity1 @entity908 @entity3885 @entity2239 @entity397 @entity1188 @entity1186 @entity583 @entity715
OBJECTIVES: The aim of this study was to evaluate the pathophysiological features and response to primary percutaneous coronary intervention (PCI) of nonruptured/eroded plaque versus @entity397 as a cause of @entity583 ( @entity583 ). BACKGROUND: Autopsy series identified nonruptured/eroded plaque and @entity397 as the principal pathological substrates underlying @entity1186 in @entity583 . The real incidence of different plaque morphologies, associated biological factors, superimposed @entity715 , and their interaction with primary PCI remain largely unknown. METHODS: In a prospective study, 140 @entity1 with @entity583 underwent optical coherence tomography of the @entity1188 ( @entity1188 ) before PCI, after @entity2239 -eluting stent implantation and at 9-month follow-up. Histopathology and immunohistochemistry of @entity715 aspirates and serum biomarkers were assessed at baseline. RESULTS: Culprit plaque morphology was adjudicated in 97 @entity1 : 32 plaques (33.0%) with an intact fibrous cap (IFC), 63 (64.9%) plaques with a ruptured fibrous cap (RFC), and 2 (2.1%) spontaneous dissections. @entity1 with an IFC and RFC had similar clinical characteristics, serum inflammatory, and platelets biomarkers. An IFC presented more frequently with a patent @entity1188 (56.2% vs. 34.9%; p  = 0.047), and had fewer lipid areas (lipid-rich areas: 75.0% vs. 100.0%; p  < 0.001) and less residual @entity715 before stenting (white @entity715 : 0.41 mm(3) vs. 1.52 mm(3); p  = 0.001; red  @entity715 : 0 mm(3) vs. 0.29 mm(3); p  = 0.001) with a lower peak of @entity908 kinase-myocardial band (66.6 UI/l vs. 149.8  UI/l; p  = 0.025). At the 9-month optical coherence tomography, IFC and RFC had similar high rates of stent strut  coverage (92.5% vs. 91.2%; p  = 0.15) and similar percentage of @entity3885 (12.6 vs. 10.2%; p  = 0.27). No  significant differences in clinical outcomes were observed up to 2 years. CONCLUSIONS: In the present study, an IFC was observed at the culprit lesion site of one-third of STEMIs. IFC, compared with RFC, was associated with higher rates of patent @entity1188 at first angiography, fewer lipid areas, and residual endoluminal @entity715 . However, no difference in vascular response to @entity2239 -eluting stent was observed. (Optical Coherence Tomography Assessment of Gender Diversity in Primary Angioplasty [OCTAVIA]; NCT01377207).
