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Coronary Computed Tomographic Angiography With Fractional Flow Reserve in Patients With Type 2 Myocardial Infarction.
McCarthy, Cian P; Murphy, Sean P; Amponsah, Daniel K; Rambarat, Paula K; Lin, Claire; Liu, Yuxi; Mohebi, Reza; Levin, Allison; Raghavan, Avanthi; Miksenas, Hannah; Rogers, Campbell; Wasfy, Jason H; Blankstein, Ron; Ghoshhajra, Brian; Hedgire, Sandeep; Januzzi, James L.
Afiliación
  • McCarthy CP; Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA. Electronic address: https://twitter.com/CianPMcCarthy.
  • Murphy SP; Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
  • Amponsah DK; Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
  • Rambarat PK; Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
  • Lin C; Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
  • Liu Y; Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
  • Mohebi R; Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
  • Levin A; Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
  • Raghavan A; Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
  • Miksenas H; Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
  • Rogers C; HeartFlow Inc, Mountain View, California, USA.
  • Wasfy JH; Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
  • Blankstein R; Department of Medicine (Cardiovascular Division) and Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA.
  • Ghoshhajra B; Division of Cardiovascular Imaging, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.
  • Hedgire S; Division of Cardiovascular Imaging, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.
  • Januzzi JL; Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA; Baim Institute for Clinical Research, Boston, Massachusetts, USA. Electronic address: jjanuzzi@mgh.harvard.edu.
J Am Coll Cardiol ; 82(17): 1676-1687, 2023 10 24.
Article en En | MEDLINE | ID: mdl-37777947
BACKGROUND: Type 2 myocardial infarction (T2MI) related to a supply/demand imbalance of coronary blood flow is common and associated with poor prognosis. Coronary artery disease (CAD) may predispose some individuals to T2MI and contribute to its high rate of recurrent cardiovascular events. Little is known about the presence and extent of CAD in this population. OBJECTIVES: The goal of this study was to evaluate the presence and characteristics of CAD among patients with T2MI. METHODS: In this prospective study, consecutive eligible individuals with Fourth Universal Definition of Myocardial Infarction criteria for T2MI were enrolled. Participants underwent coronary computed tomography angiography (CTA), fractional flow reserve derived with coronary CTA (FFRCT), and plaque volume analyses. RESULTS: Among 50 participants, 25 (50%) were female, and the mean age was 68.0 ± 11.4 years. Atherosclerotic risk factors were common. Coronary CTA revealed coronary plaque in 46 participants (92%). A moderate or greater stenosis (≥50%) was identified in 42% of participants, and obstructive disease (≥50% left main stenosis or ≥70% stenosis in any other epicardial coronary artery) was present in 26%. Prevalence of obstructive CAD did not differ according to T2MI cause (P = 0.54). A hemodynamically significant focal stenosis identified by FFRCT was present in 13 participants (26%). Among participants with a stenosis ≥50% (n = 21), FFRCT excluded lesion-specific hemodynamically significant stenosis in 8 cases (38%). CONCLUSIONS: Among individuals with adjudicated T2MI, CAD was prevalent, but the majority of patients had nonobstructive CAD. Mediators of ischemia are likely multifactorial in this population. (Defining the Prevalence and Characteristics of Coronary Artery Disease Among Patients with Type 2 Myocardial Infarction using CT-FFR [DEFINE TYPE 2 MI]; NCT04864119).
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de la Arteria Coronaria / Estenosis Coronaria / Reserva del Flujo Fraccional Miocárdico / Infarto de la Pared Anterior del Miocardio / Placa Aterosclerótica / Infarto del Miocardio Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Am Coll Cardiol Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de la Arteria Coronaria / Estenosis Coronaria / Reserva del Flujo Fraccional Miocárdico / Infarto de la Pared Anterior del Miocardio / Placa Aterosclerótica / Infarto del Miocardio Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Am Coll Cardiol Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos