T Sheth1, M K Natarajan2, V Hsieh3, N Valettas2, M Rokoss2, S Mehta2, S Jolly2, V Tandon2, H Bezerra4, P J Devereaux5. 1. Population Health Research Institute, Hamilton Health Sciences and Department of Medicine, McMaster University, Hamilton General Hospital, Hamilton, ON, Canada. Electronic address: shetht@mcmaster.ca. 2. Population Health Research Institute, Hamilton Health Sciences and Department of Medicine, McMaster University, Hamilton General Hospital, Hamilton, ON, Canada. 3. Division of Cardiology, St. George Hospital, Sydney, Australia. 4. Division of Cardiology, Case Western Reserve University, Cleveland, OH, USA. 5. Population Health Research Institute, Hamilton Health Sciences and Department of Medicine, McMaster University, Hamilton General Hospital, Hamilton, ON, Canada; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
Abstract
BACKGROUND: The contribution of thrombosis to the aetiology of perioperative myocardial infarction (MI) is uncertain. We used optical coherence tomography (OCT) to determine the presence of thrombus and plaque morphology in patients experiencing a perioperative MI and matched patients experiencing a non-operative MI using OCT. METHODS: We conducted a single-centre, prospective, cohort study. Thirty patients experiencing a perioperative MI and 30 matched patients experiencing a non-operative MI, without ST elevation, underwent OCT to determine the presence of thrombus and culprit lesion plaque morphology. Angiography and OCT were performed a mean of 1.93(1.09) days and 1.53(0.68) days after the onset of perioperative and non-operative MI, respectively. OCT images were evaluated by an independent core laboratory without knowledge of whether the patient had suffered a perioperative or non-operative MI. RESULTS: We identified thrombus at the culprit lesion in four of 30 patients (13.3%) who experienced a perioperative MI and in 20 of 30 patients (66.7%) who experienced a non-operative MI, P<0.01. The only non-culprit lesion with thrombus was in a perioperative MI patient who also had a culprit lesion thrombus. Perioperative and non-operative MI culprit lesions demonstrated fibroatheroma in 18 patients (60.0%) us 20 patients (66.7%), respectively (P=0.52) and thin cap fibroatheroma in one patient (3.3%) us five patients (16.7%), respectively (P=0.11). One perioperative MI patient (3.3%) suffered a cardiac death and no non-operative MI patient died during the 30-day follow-up. CONCLUSIONS: Thrombosis was less common in perioperative than non-operative MI, despite similar underlying plaque morphology.
BACKGROUND: The contribution of thrombosis to the aetiology of perioperative myocardial infarction (MI) is uncertain. We used optical coherence tomography (OCT) to determine the presence of thrombus and plaque morphology in patients experiencing a perioperative MI and matched patients experiencing a non-operative MI using OCT. METHODS: We conducted a single-centre, prospective, cohort study. Thirty patients experiencing a perioperative MI and 30 matched patients experiencing a non-operative MI, without ST elevation, underwent OCT to determine the presence of thrombus and culprit lesion plaque morphology. Angiography and OCT were performed a mean of 1.93(1.09) days and 1.53(0.68) days after the onset of perioperative and non-operative MI, respectively. OCT images were evaluated by an independent core laboratory without knowledge of whether the patient had suffered a perioperative or non-operative MI. RESULTS: We identified thrombus at the culprit lesion in four of 30 patients (13.3%) who experienced a perioperative MI and in 20 of 30 patients (66.7%) who experienced a non-operative MI, P<0.01. The only non-culprit lesion with thrombus was in a perioperative MI patient who also had a culprit lesion thrombus. Perioperative and non-operative MI culprit lesions demonstrated fibroatheroma in 18 patients (60.0%) us 20 patients (66.7%), respectively (P=0.52) and thin cap fibroatheroma in one patient (3.3%) us five patients (16.7%), respectively (P=0.11). One perioperative MI patient (3.3%) suffered a cardiac death and no non-operative MI patient died during the 30-day follow-up. CONCLUSIONS:Thrombosis was less common in perioperative than non-operative MI, despite similar underlying plaque morphology.
Authors: Flavia K Borges; Tej Sheth; Ameen Patel; Maura Marcucci; Terence Yung; Thomas Langer; Carolina Alboim; Carisi Anne Polanczyk; Federico Germini; Andre Ferreira Azeredo-da-Silva; Erin Sloan; Kendeep Kaila; Ron Ree; Alessandra Bertoletti; Maria Cristina Vedovati; Antonio Galzerano; Jessica Spence; P J Devereaux Journal: CJC Open Date: 2020-07-17
Authors: Nicholas J Douville; Ida Surakka; Aleda Leis; Christopher B Douville; Whitney E Hornsby; Chad M Brummett; Sachin Kheterpal; Cristen J Willer; Milo Engoren; Michael R Mathis Journal: Circ Genom Precis Med Date: 2020-06-09
Authors: Ketina Arslani; Danielle M Gualandro; Christian Puelacher; Giovanna Lurati Buse; Andreas Lampart; Daniel Bolliger; David Schulthess; Noemi Glarner; Reka Hidvegi; Christoph Kindler; Steffen Blum; Francisco A M Cardozo; Bruno Caramelli; Lorenz Gürke; Thomas Wolff; Edin Mujagic; Stefan Schaeren; Daniel Rikli; Carlos A Campos; Gregor Fahrni; Beat A Kaufmann; Philip Haaf; Michael J Zellweger; Christoph Kaiser; Stefan Osswald; Luzius A Steiner; Christian Mueller Journal: Sci Rep Date: 2022-03-15 Impact factor: 4.379