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Is Compensatory Enlargement The
Predominant Pattern in Acute Myocardial
Infarction? IVUS Insights from
The Culprit Lesion
Tarbine, Sergio; Zanuttini, Daniel;
Freitas, Marcelo; Gama, Ricardo;
Lerner, Sergey; Medeiros, Marco;
Scorsin, Marcio; Franchetti, Marcos;
Clínica Cardiológyca C. Costantini, Curitiba, Paraná, Brazil
Background: Recent reports indicate that vessel remodeling produced as a plaque development is variable among individuals, and that compensatory enlargement might be present in acute coronary syndromes. The objective of the present study is to investigate remodeling and other vessel characteristics in patients (pts) with acute myocardial infarction (AMI).
Methods: Since 06/98 through 03/01 125 <12 hs. AMI pts, 26.4%female, mean age 65.5+/-33.2yrs, underwent direct PTCA, 71.2% with stenting. Admission Killip class was III, IV and Non standard (CPR; A-V block; malignant arrhythmia) in 16.8%. Anterior wall MI was present in 43.2%. IVUS was performed in 74 pts, being 64.8% after recanalization. Vessel area (VA), Lumen area (LA), and plaque area (PA) at the culprit site and at the reference segments were measured. The remodeling index was calculated as (VA at the lesion site)/(VA at the proximal reference).
Results: Compensatory enlargement was present in 70.8%. Any calcification was seen in 42.8%. Plaque composition was: mixed 62%, soft 28% and hard in 8%.
Conclusions: Compensatory enlargement was the predominant remodeling pattern in this cohort of patients. Luminal and plaque areas had not statistical significance when compared to those from vessels without this kind of vessel remodeling.
2nd Virtual Congress of Cardiology
Dr. Florencio Garófalo
Dr. Raúl Bretal
Dr. Armando Pacher
Technical Committee - CETIFAC
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