Myocardial Infarction Clinical Trial
Official title:
Pre-intervention and Post-intervention Optical Coherence Tomography Examination for Culprit Lesion in Patients With ST-segment Elevation Myocardial Infarction
Different plaque morphology may have an important effect on the prognosis of acute myocardial infarction (AMI), as recent studies show that patients with plaque rupture have a significantly higher risk of cardiac events compared with those with plaque erosion. The primary purpose of this study is to find risk factors and biomarkers for different culprit lesion morphology to perform accurate risk stratification and determine an appropriate treatment strategy for patients with AMI.
Acute myocardial infarction (AMI), which results from coronary artery occlusion due to
thrombosis, remains the leading cause of death and disability worldwide. Pathological studies
have demonstrated that plaque rupture accompanied by subsequent thrombus formation is the
main mechanism responsible for AMI, accounting for approximately two thirds of cases; the
remaining approximately one third of cases are the result of plaque erosion. Moreover,
previous studies showed that the risk of cardiovascular events is significantly higher in
patients with plaque rupture compared to those with plaque erosion. The EROSION study
suggested that in patients with acute coronary syndrome presenting with plaque erosion,
conservative treatment with anti-thrombotic therapy may be a reasonable option instead of
stents implantation. Therefore, it is important to differentiate between the culprit
morphologies in order to perform an accurate risk stratification and determine a personalized
treatment strategy with the goal to improve the prognosis of patients with AMI.
Optical coherence tomography (OCT), a newly developed high resolution near infrared
light-based intravascular imaging modality, can visualize the microstructure of
atherosclerotic plaques such as the fibrotic cap, lipid pool, thrombi, and so on, and has
been considered as the golden standard for differentiating plaque morphology in vivo.
In this study, we aimed to find risk factors and biomarkers for culprit lesion morphology as
assessed by OCT.
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