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Plaque erosion caused by acute coronary syndrome or without stent placement

2017-08-05

The results of the EROSION study conducted by Professor Yu Bo, Second Affiliated Hospital of Harbin Medical University, show that about one quarter of acute coronary syndromes (ACS) are caused by plaque erosion rather than plaque rupture. These patients need no stent, Only receiving antithrombotic therapy is sufficient to restore blood flow and avoid stent-related complications. (EurHeartJ. August 30 online version)

A study of 405 patients with ACS was diagnosed by optical coherence tomography (OCT). The results showed that 103 cases (25.4%) patients with plaque erosion, of which 60 cases of coronary artery stenosis <70%, TIMI blood flow 3, and stable condition.Patients were given 60 patients with heparin + double antiplatelet therapy (aspirin + tegrelol) and were given by the doctor to determine whether to administer glycoprotein IIb / IIIa inhibitor (63%) or manual thrombosis (85%).

One month after follow-up, 47 patients (78.3%) had thrombosis more than 50%, 22 of whom had no visible thrombosis. The median thrombus volume was reduced from 3.7 mm3 to 0.2 mm3, and the median minimum blood flow increased from 1.7 mm2 to 2.1 mm2. 1 patient died of gastrointestinal bleeding, the other 1 patients need to be stent, other patients asymptomatic.Researchers say that if ACS patients are identified by plaque erosion in advance by OCT, it may be possible to avoid placing the stent.


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