Yu Hua, Ma Likun, Feng Kefu, Chen Hongwu, Hu Hao
Department of Cardiology, Anhui Provincial Hospital of Anhui Medical University, Hefei, China.
Heart Surg Forum. 2017 Feb 28;20(1):E032-E037. doi: 10.1532/hsf.1447.
This study aimed to evaluate the clinical significance and safety of optical coherence tomography (OCT) in patients with non-ST-elevation acute coronary syndrome (NSTEACS) combined with intermediate lesions.
Sixty-five NSTEACS patients with intermediate lesions confirmed with coronary angiography at our department were included in this study. Among them, 33 patients received only standardized drug treatment (drug group) and the other 32 patients received percutaneous coronary intervention (PCI) according to the OCT examination based on drug treatment (OCT group). Major adverse cardiovascular events (MACEs), revascularization, success rate of OCT examination, related complications, and other patient situations in the two groups during hospitalization and the 12-month follow-up period were compared.
No death or stroke occurred in either group during hospitalization and follow-up. In the drug treatment group, six patients experienced frequent angina, and five patients with acute myocardial infarction were rehospitalized and underwent PCI procedures. In the OCT group, although two patients underwent repeat revascularization, no additional acute myocardial infarction events occurred. There was a statistically significant difference between the two groups (P < .01). All patients in the OCT group successfully completed the related vessel examination, and 24 patients underwent PCI procedures because of unstable plaque diagnosed with OCT.
OCT-guided PCI is safe and effective for the treatment of patients with NSTEACS combined with intermediate lesions.
本研究旨在评估光学相干断层扫描（OCT）在非ST段抬高型急性冠状动脉综合征（NSTEACS）合并中度病变患者中的临床意义及安全性。
选取我院心内科经冠状动脉造影确诊为中度病变的65例NSTEACS患者。其中33例患者仅接受标准化药物治疗（药物组），另外32例患者在药物治疗基础上根据OCT检查结果接受经皮冠状动脉介入治疗（PCI）（OCT组）。比较两组患者住院期间及12个月随访期内的主要不良心血管事件（MACE）、血管重建情况、OCT检查成功率、相关并发症及其他患者情况。
两组患者在住院及随访期间均未发生死亡或卒中。药物治疗组有6例患者出现频繁心绞痛，5例急性心肌梗死患者再次住院并接受了PCI手术。OCT组虽有2例患者接受了再次血管重建，但未发生额外的急性心肌梗死事件。两组间差异有统计学意义（P <.01）。OCT组所有患者均成功完成相关血管检查，24例患者因OCT诊断为不稳定斑块而接受了PCI手术。
OCT引导下的PCI治疗NSTEACS合并中度病变患者安全有效。
