A combination of plaque components analyzed by integrated backscatter intravascular ultrasound and serum pregnancy-associated plasma protein a levels predict the no-reflow phenomenon during percutaneous coronary intervention.

Abstract

AIMS:

Previous studies reported that integrated backscatter intravascular ultrasound (IB-IVUS) provides high diagnostic accuracy for tissue characterization of coronary plaques and that pregnancy-associated plasma protein A (PAPP-A) could be a marker of adverse cardiac outcome in patients with cardiovascular disease. We examined whether IB-IVUS and PAPP-A levels could predict the incidence of no-reflow during percutaneous coronary intervention (PCI) METHODS AND RESULTS: About 176 consecutive patients (138 men, mean age 68 ± 11 years) who underwent PCI with IB-IVUS were prospectively enrolled. Combined no-reflow, including transient filter no-reflow by using distal protection devices, was observed in 31 patients. The percentages of coronary lipid volume (%LV) analyzed by IB-IVUS and serum PAPP-A were significantly higher in patients with combined no-reflow than normal-reflow. To predict no-reflow, a receiver operating characteristic (ROC) analysis determined cut-off values of %LV as 62% and serum PAPP-A as 7.71 ng/mL. The multivariate logistic regression analysis showed that %LV (hazard ratio 4.5, 95% confidence interval 1.6-13.4, P < 0.01) and PAPP-A (hazard ratio 4.32, 95% confidence interval 1.5-12.7, P < 0.01) were independent predictors of combined no-reflow

CONCLUSIONS:

%LV analyzed by IB-IVUS and serum PAPP-A levels were closely associated with the coronary no-reflow phenomenon. © 2014 Wiley Periodicals, Inc.

• Authors: Hyuma Daidoji, Hiroki Takahashi, Yoichiro Otaki, Harutoshi Tamura, Takanori Arimoto, Tetsuro Shishido, Takehiko Miyashita, Takuya Miyamoto, Tetsu Watanabe, Isao Kubota
• Journal: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions (Catheter Cardiovasc Interv) Vol. 85 Issue 1 Pg. 43-50 (Jan 01 2015) ISSN: 1522-726X [Electronic] United States
• PMID: 24227626 (Publication Type: Journal Article)
• Copyright: © 2013 Wiley Periodicals, Inc.

Chemical References

• Biomarkers
• Pregnancy-Associated Plasma Protein-A
• PAPPA protein, human

Topics

• Aged
• Area Under Curve
• Biomarkers (blood)
• Coronary Artery Disease (blood, diagnostic imaging, therapy)
• Coronary Circulation
• Coronary Vessels (diagnostic imaging)
• Female
• Humans
• Logistic Models
• Male
• Middle Aged
• Multivariate Analysis
• No-Reflow Phenomenon (blood, diagnosis, etiology, physiopathology)
• Percutaneous Coronary Intervention (adverse effects)
• Plaque, Atherosclerotic
• Predictive Value of Tests
• Pregnancy-Associated Plasma Protein-A (analysis)
• Proportional Hazards Models
• Prospective Studies
• ROC Curve
• Risk Factors
• Treatment Outcome
• Ultrasonography, Interventional