Clinical & Experimental Cardiology
Open Access
ISSN: 2155-9880
+44 1300 500008
ISSN: 2155-9880
+44 1300 500008
Alejandro Gutierrez Barrios
Posters-Accepted Abstracts: J Clin Exp Cardiolog
Patients presenting with typical symptoms of acute coronary syndrome (ACS) but without critical obstruction on visual angiography have a prognosis that is not as benign as previously thought. The pathogenesis of ACS without coronary obstruction is complex and not fully clarified, the study of intracoronary optical coherence tomography (OCT) may help to clarify it. Methods: A retrospective observational study of ST elevation myocardial infarction (STEMI) patients without obstruction at angiography was performed. Between April 2012 and August 2013 eleven patientswith STEMI and with nonobstructive coronary artery disease incoronary angiography was referred for primary angioplasty. OCT was performed in all the patients. Results: Mean age 56�12 years,males (63%), hypertension (36%), type 2DM(18%), Dyslipidemia(36%) and smoking (46%). Responsiblemyocardial territorywas theleft anterior descendingin 73%. 45.5% had some alteration insegmental contractility. In 45% of the angiographies no alteration was found and in the remainder minor alterations were found: mild stenosis(27%), discreteradiolucent image(18%), light contrast retention (9%). OCT was performed in the responsible vessel and in the vessel in which a minor finding was observed during coronariography. In 56%theOCTdid not identify anyabnormalityin27% a culprit lesion with ulceration and /or adhered thrombus was identified, in one case a small fissure was detected and in another case remains of thrombotic material without culprit lesion was found. The concordance between coronariography and OCT was moderates incein 27% of cases with mild coronariography findings nothing was found in the OCT and in the cases with findings in OCT, 20% of them had normal coronariography. Of the 3 patients with mild angiographic stenosis a culprit ulcerated lesion was found in two of them, and of the 2 cases with radio lucent image in one of them aculprit lesion was identified with the OCT. Stent was implanted in 3 (27%) cases in which a culprit and unstable lesion was identified despite not visualizing angiographic stenosis. In the case of coronary fissure, conservative management and clinical follow up was performed with repeating coronariographies and OCT studies untilcomplete resolution was achieved. Themean follow-up of 21�5 months revealed all patients were asymptomatic with no clinical event reported. Conclusion: OCT study may influence the therapeutic approach to patients with STEMI with normal or near normal coronary arteries.
Alejandro Gutierrez Barrios graduated from Cadiz University (Spain) in 2001 at the age of 24 years. After graduation he moved to Puerta Del Mar University Hospital in Cadiz where he completed his residency in cardiovascular medicine and a fellowship in interventional cardiology (2002-2007). In 2009 he moved to Jerez University Hospital to take up his current position as interventional cardiologist and Assistant Professor of cardiovascular medicine. He is a member of the European Society of Cardiology. He has several publications in peer-reviewed journals and more than 20 presentations in national and international cardiology conferences.