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  • Ovid Technologies (Wolters Kluwer Health)  (6)
  • Yokoyama, Hiroaki  (6)
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  • Ovid Technologies (Wolters Kluwer Health)  (6)
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  • 1
    Online Resource
    Online Resource
    Prasugrel versus clopidogrel for residual thrombus burden in patients with ST-segment elevation myocardial infarction : an optical coherence tomography study
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  Coronary Artery Disease Vol. 29, No. 8 ( 2018-12), p. 663-669
    Details
    In: Coronary Artery Disease, Ovid Technologies (Wolters Kluwer Health), Vol. 29, No. 8 ( 2018-12), p. 663-669
    Type of Medium: Online Resource
    ISSN: 0954-6928
    URL: Article
    DOI: 10.1097/MCA.0000000000000663
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
    detail.hit.zdb_id: 2042449-8
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  • 2
    Online Resource
    Online Resource
    Abstract 16483: Marital Status and Long-Term Mortality of Male Patients Presenting With Acute Myocardial Infarction
    Ovid Technologies (Wolters Kluwer Health) ; 2014
    In:  Circulation Vol. 130, No. suppl_2 ( 2014-11-25)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 130, No. suppl_2 ( 2014-11-25)
    Abstract: Background: Although unmarried has been associated with an increased risk of acute coronary syndrome, little is known about the relationship between marital status and long-term mortality after acute myocardial infarction (AMI). Methods and Results: To elucidate the clinical characteristics and outcomes of AMI patients who have never married, the consecutive 364 male AMI patients (mean age; 63±13 years) admitted to our hospital were studied. Mean follow-up period was 1.7 years. The patients were divided into 2 groups by their marital status: those who had married at least one time (Married Group (MG), n=328) and those who had never married (Unmarried Group (UG), n=36 (9.9%)). UG patients were younger (54±11 vs 65±12 years, p 〈 0.0001) and had a higher level of body mass index (BMI) (26.5±4.5 vs 24.1±3.5 kg/m2, p=0.0002) than MG. None of coronary risk factors including hypertension, dyslipidemia, diabetes mellitus and smoking habit, Killip classification, culprit lesion of AMI nor maximal creatine phosphokinase-MB (CPK-MB) level was different between 2 groups. The time from the symptom onset to admission was significantly longer in UG (6.1 (2.6-14.3) vs 3.8 (2.3-8.3) hours, p=0.033). Left ventricular ejection fraction (LVEF) assessed at the acute phase of AMI was not different between 2 groups. Kaplan-Meier Curve showed no significant difference of all-cause mortality between 2 groups (20% in UG vs 12% in MG, p=0.27 by Log-rank test). When the analysis is done in patients with the ages 〉 50 years (272 patients in MG and 19 in UG), all-cause mortality tended to be higher in UG than in MG (38% vs 15%, p=0.098 by Log-rank test). After adjustment for age, Killip IV and LVEF at the acute phase, unmarried status was independently associated with all-cause long-term mortality after AMI (hazard ratio (HR); 3.84, 95% confidence interval (CI); 1.22-10.2, p=0.024). Conclusions: Unmarried status is independently associated with significantly increased all-cause long-term mortality in the male AMI patients with the ages 〉 50 years.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.130.suppl_2.16483
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
    detail.hit.zdb_id: 1466401-X
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  • 3
    Online Resource
    Online Resource
    Abstract 13930: Culprit Lesion in Patients With ST-elevation Myocardial Infarction is Severely Narrowed With Large Plaque Burden: A Combined Intravascular Ultrasound and Optical Coherence Tomography Study
    Ovid Technologies (Wolters Kluwer Health) ; 2015
    In:  Circulation Vol. 132, No. suppl_3 ( 2015-11-10)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 132, No. suppl_3 ( 2015-11-10)
    Abstract: Background: There have been controversies on the degree of stenosis of the culprit lesion in patients with ST-elevation myocardial infarction (STEMI). In the past it was thought the culprit lesion for STEMI had only mild to moderate stenosis. However, recent studies suggested that in fact the degree of the luminal narrowing might be severe at the culprit site. Aim: The aim of the current study was to investigate the severity and the detailed morphologic characteristics of the culprit lesion in patients with STEMI using intravascular ultrasound (IVUS) and optical coherence tomography (OCT). Methods and Results: A total of 111 STEMI patients (67.8±11.2 years, 89 male) who underwent percutaneous coronary intervention within 12 hours from symptom onset were included. TIMI flow grade 2 or 3 was achieved in 108 (97%) patients after thrombectomy. Both OCT and IVUS were performed. Minimum lumen cross-sectional area (MLA) and plaque burden (PB) were 3.14±1.45 mm 2 and 83.0±7.24% by IVUS. Patients were divided into 2 groups on the basis of MLA by IVUS: Group A (MLA 〈 4 mm 2 , n=104) and Group B (MLA 〉 4 mm 2 , n=7). Group A had a higher incidence of PB 〉 70% compared to Group B (99.0% vs 28.6%, p 〈 0.001). OCT revealed that lipid plaque, microchannel and macrophage were more frequent in Group A than in Group B. The incidence of plaque rupture tended to be higher in Group A than in Group B (Figure). Conclusions: Among STEMI patients, more than 90% of culprit lesions have a small MLA ( 〈 4.0 mm 2 ) with large plaque burden. Severely narrowed culprit lesion had more features of vulnerability.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.132.suppl_3.13930
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2015
    detail.hit.zdb_id: 1466401-X
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  • 4
    Online Resource
    Online Resource
    Coronary Plaque Characteristics Associated With Reduced TIMI (Thrombolysis in Myocardial Infarction) Flow Grade in Patients With ST-Segment–Elevation Myocardial Infarction : A Combined Optical Coherence Tomography and Intravascular Ultrasound Study
    Ovid Technologies (Wolters Kluwer Health) ; 2016
    In:  Circulation: Cardiovascular Interventions Vol. 9, No. 9 ( 2016-09)
    Details
    In: Circulation: Cardiovascular Interventions, Ovid Technologies (Wolters Kluwer Health), Vol. 9, No. 9 ( 2016-09)
    Abstract: Previous studies reported that reduced TIMI (Thrombolysis in Myocardial Infarction) flow grade before procedure was associated with worse clinical outcomes in patients with ST-segment–elevation myocardial infarction undergoing primary percutaneous coronary intervention. The aim of this study was to identify specific morphological characteristics of the culprit plaque associated with poor TIMI flow grade at baseline in patients with ST-segment–elevation myocardial infarction using both optical coherence tomography and intravascular ultrasound. Methods and Results— A total of 111 ST-segment–elevation myocardial infarction patients who underwent percutaneous coronary intervention within 24 hours of symptom onset were included. Both optical coherence tomography and intravascular ultrasound were performed after thrombectomy. Patients were divided into 2 groups according to preprocedural TIMI flow grade (TIMI 0–1 [n=82] and TIMI 2–3 [n=29] ). Patients with preprocedural TIMI 0 to 1 had a greater lipid arc ( P =0.037), a longer lipid length ( P =0.021), and a greater lipid index ( P =0.007) determined by optical coherence tomography and a larger external elastic membrane cross-sectional area ( P =0.030) and plaque plus media cross-sectional area ( P =0.030) determined by intravascular ultrasound, compared with patients with preprocedural TIMI 2 to 3. Conclusions— ST-segment–elevation myocardial infarction patients with reduced TIMI flow grade at baseline have greater lipid burden, larger vessel sizes, and larger plaque areas.
    Type of Medium: Online Resource
    ISSN: 1941-7640 , 1941-7632
    URL: Article
    DOI: 10.1161/CIRCINTERVENTIONS.116.003913
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2016
    detail.hit.zdb_id: 2450801-9
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  • 5
    Online Resource
    Online Resource
    Coronary Calcification and Plaque Vulnerability : An Optical Coherence Tomographic Study
    Ovid Technologies (Wolters Kluwer Health) ; 2016
    In:  Circulation: Cardiovascular Imaging Vol. 9, No. 1 ( 2016-01)
    Details
    In: Circulation: Cardiovascular Imaging, Ovid Technologies (Wolters Kluwer Health), Vol. 9, No. 1 ( 2016-01)
    Abstract: Spotty superficial calcium deposits have been implicated in plaque vulnerability based on previous intravascular imaging studies. Biomechanical models suggest that microcalcifications between 5 and 65 µm in diameter can intensify fibrous cap stress, promoting plaque rupture. However, the 100- to 200-µm resolution of intravascular ultrasound limits its ability to discriminate single calcium deposits from clusters of smaller deposits, and a previous optical coherence tomographic investigation evaluated calcifications within a long segment of artery, which may not truly reflect the mechanics involved in potentiating focal plaque rupture. Methods and Results— Detailed optical coherence tomographic assessment of coronary calcification at the culprit plaque (10-mm length) was performed in 53 patients with acute ST-segment–elevation myocardial infarction mediated by plaque rupture and 55 patients with stable angina pectoris. The number and longitudinal length of individual calcium deposits were recorded. Cross-sectional images were analyzed every 1 mm for calcium arc and depth, and these quantitative parameters were used to define individual deposits as spotty, large, and superficial. There was no significant difference between ST-segment–elevation myocardial infarction mediated by plaque rupture and stable angina pectoris groups in the number of total ( P =0.58), spotty ( P =0.87), or large calcium deposits ( P =0.27). Minimum calcium depth was similar between groups ( P =0.27), as was the number of superficial deposits ( P =0.35 using a 65-µm depth threshold and P =0.84 using a 100-µm depth threshold). Conclusions— The number and pattern of culprit plaque calcifications did not differ between patients presenting with ST-segment–elevation myocardial infarction mediated by plaque rupture versus stable angina pectoris. The optical coherence tomographic assessment of coronary calcification may not be a useful marker of local plaque vulnerability as previously suspected. Registration Information— URL: http://www.clinicaltrials.gov . Unique identifier: NCT01110538.
    Type of Medium: Online Resource
    ISSN: 1941-9651 , 1942-0080
    URL: Article
    DOI: 10.1161/CIRCIMAGING.115.003929
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2016
    detail.hit.zdb_id: 2440475-5
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  • 6
    Online Resource
    Online Resource
    Abstract 16100: Incidence and Morphologic Characteristics of Plaque Erosion in Patients With Acute Myocardial Infarction: A Combined Optical Coherence Tomography and Intravascular Ultrasound Study
    Ovid Technologies (Wolters Kluwer Health) ; 2014
    In:  Circulation Vol. 130, No. suppl_2 ( 2014-11-25)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 130, No. suppl_2 ( 2014-11-25)
    Abstract: Background: The underlying mechanisms for acute myocardial infarction (AMI) include plaque rupture (PR), plaque erosion (PE), and calcific nodule (CN). Recently, in vivo diagnosis of PE was reported in patients with acute coronary syndromes (ACS) using optical coherence tomography (OCT). However, the true incidence of erosion in patients with AMI remains unknown. Aim: The aims of this study were (1) to evaluate the incidence of PR, PE, and CN in patients with AMI during the acute phase and (2) to compare the detailed plaque morphology in all 3 groups using both OCT and intravascular ultrasound (IVUS). Methods and Results: In 77 patients with AMI, both OCT and IVUS were performed following manual aspiration thrombectomy. Culprit plaques were classified into PR, PE, and CN using the established OCT criteria. The frequency of PR, PE, and CN were 62.3%, 27.2%, and 6.5%, respectively. PE had significantly lower prevalence of thin-cap fibroatheroma (TCFA), thicker fibrous cap and smaller lipid arc. Compared to PR and PE, CN had greater calcification (Table). On IVUS, plaque eccentricity index was significantly greater in PE compared to the others. PR and PE showed greater plaque burden. The remodeling index was different among these 3 groups. 75.0% of PR had positive remodeling but none in CN. In contrast, CN had higher prevalence of negative remodeling. The prevalence of superficial spotty calcification was higher in PR than the other 2 groups. Conclusion: This combined OCT and IVUS study demonstrates that erosion was the underlying mechanism in 27.2% of patients with AMI. In eroded plaques, TCFA was rare and eccentricity index was significantly greater.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.130.suppl_2.16100
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
    detail.hit.zdb_id: 1466401-X
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