الفهرس 
Optical coherence tomography characterization of culprit lesion in st-segment elevation myocardial infarction
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Abstract
Background: Optical coherence tomography (OCT) classifies culprit lesions morphology in patients with ST elevation myocardial infarction (STEMI) into plaques with ruptured fibrous cap (RFC) or intact fibrous cap (IFC). There is persistent uncertainty about the contribution of both to the pathogenesis of atherothrombosis and infarction. Previous studies showed dominating prevalence of plaque ruptures. Our aim is to identify the prevalence of IFC and RFC assessed by OCT and to study patient- and plaque-related features in a STEMI cohort presenting for primary PCI Methods: OCT was performed after thrombus 136 STEMI patients. Studies with excess residual thrombus burden (n=73) precluding complete culprit lesion assessment were excluded. Results: In the 63 interpretable cases, IFC occurred in 30 (48%) and RFC in 33 cases (52%). Patients with IFC were younger in age. The presence of {u2265}2 traditional risk factors for coronary artery disease (hypertension, diabetes mellitus, dyslipidemia, obesity and smoking) was less prevalent in patients with IFC than with RFC (23.1% vs 56.2%; p=0.011). Other patient- and lesion-related features are summarized in table. At 6 months follow up, there was no significant difference of MACE between both groups defined as (mortality p=0.36 or re-hospitalization for recurrent chest pain p=0.29, respectively). Conclusion: In our cohort of STEMI patients, IFC occurred at a higher prevalence than that reported in Western countries, possibly because of the younger age at STEMI presentation, and had lower burden of traditional coronary artery disease risk factors and thicker culprit plaque fibrous caps