9 results on '"Inaba, Shinji"'
Search Results
2. Isolated Negative Vessel Remodeling-Induced Myocardial Ischemia.
- Author
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Sakaue T, Inaba S, Morioka H, Sumimoto T, and Saito M
- Subjects
- Acute Coronary Syndrome diagnostic imaging, Acute Coronary Syndrome drug therapy, Adrenergic beta-1 Receptor Antagonists therapeutic use, Aged, Calcium Channel Blockers therapeutic use, Coronary Stenosis diagnostic imaging, Coronary Stenosis drug therapy, Coronary Vasospasm diagnostic imaging, Coronary Vasospasm drug therapy, Coronary Vessels diagnostic imaging, Coronary Vessels drug effects, Humans, Male, Non-ST Elevated Myocardial Infarction diagnostic imaging, Treatment Outcome, Acute Coronary Syndrome physiopathology, Coronary Stenosis physiopathology, Coronary Vasospasm physiopathology, Coronary Vessels physiopathology, Non-ST Elevated Myocardial Infarction physiopathology, Vascular Remodeling drug effects, Vasoconstriction drug effects
- Published
- 2020
- Full Text
- View/download PDF
3. Relationship between left main coronary artery plaque burden and nonleft main coronary atherosclerosis: results from the PROSPECT study.
- Author
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Shimizu T, Mintz GS, De Bruyne B, Farhat NZ, Inaba S, Cao Y, Marso SP, Weisz G, Serruys PW, Stone GW, and Maehara A
- Subjects
- Acute Coronary Syndrome pathology, Acute Coronary Syndrome surgery, Aged, Coronary Artery Disease pathology, Coronary Artery Disease surgery, Coronary Vessels pathology, Coronary Vessels surgery, Female, Humans, Male, Middle Aged, Percutaneous Coronary Intervention adverse effects, Predictive Value of Tests, Risk Factors, Severity of Illness Index, Time Factors, Treatment Outcome, Acute Coronary Syndrome diagnostic imaging, Coronary Artery Disease diagnostic imaging, Coronary Vessels diagnostic imaging, Plaque, Atherosclerotic, Ultrasonography, Interventional
- Abstract
Objectives: Whether the severity of left main coronary artery (LMCA) disease reflects LMCA and overall coronary atherosclerotic burden is not known. We aimed to assess nonculprit LMCA disease characteristics and the relationship with atherosclerosis in the rest of the coronary arteries as well as patient outcomes., Patients and Methods: In the PROSPECT study, 697 patients with acute coronary syndromes underwent three-vessel gray-scale and radiofrequency intravascular ultrasound after percutaneous coronary intervention., Results: Overall, 552 patients with adequate LMCA imaging were compared according to LMCA plaque burden. The tertile with the highest plaque burden in the LMCA had the smallest LMCA minimum lumen area (17.4, 14.2, 10.5, lowest through highest tertiles, respectively, P<0.0001) and the greatest percent necrotic core volume (2.8, 5.6, 9.5%, lowest through highest tertiles, respectively, P<0.0001). Furthermore, the tertile with the highest plaque burden was also significantly associated with the highest overall non-LMCA percent atheroma volume within the major epicardial arteries (48.3, 49.2, 50.8%, lowest through highest tertiles, respectively, P<0.0001). After adjusting for patient background, the LMCA plaque burden was independently associated with non-LMCA percent atheroma volume (P=0.003). Of the three PROSPECT predictors of future nonculprit major adverse cardiac events (MACE) (minimum lumen area≤4 mm, plaque burden≥70%, and virtual histology thin-cap fibroatheroma), the tertile with the highest LMCA plaque burden had the highest number of patients with at least one of three PROSPECT predictors (P=0.03). In multivariable model, though total atheroma volume (per 1%) was an independent predictor of all MACE [hazard ratio (95% confidence interval)=1.06 (1.01-1.11), P=0.02] and strong trend for non-culprit-related MACE [hazard ratio (95% confidence interval)=1.06 (1.00-1.13), P=0.06], plaque burden at LMCA was not (all MACE, P=0.90, non-culprit-related MACE, P=0.85)., Conclusion: The severity of atherosclerosis in LMCA predicted the overall atherosclerotic plaque burden as well as the presence of high-risk plaques in the three major epicardial coronary arteries.
- Published
- 2018
- Full Text
- View/download PDF
4. Intravascular Ultrasound and Near-Infrared Spectroscopic Characterization of Thin-Cap Fibroatheroma.
- Author
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Inaba S, Mintz GS, Burke AP, Stone GW, Virmani R, Matsumura M, Parvataneni R, Puri R, Nicholls SJ, and Maehara A
- Subjects
- Aged, Autopsy, Coronary Artery Disease pathology, Coronary Vessels pathology, Female, Humans, Male, Middle Aged, Plaque, Atherosclerotic pathology, Sensitivity and Specificity, Vascular Remodeling, Coronary Artery Disease diagnostic imaging, Coronary Vessels diagnostic imaging, Plaque, Atherosclerotic diagnostic imaging, Spectroscopy, Near-Infrared, Ultrasonography, Interventional
- Abstract
Thin-cap fibroatheromas (TCFAs) are considered precursors for plaque rupture and subsequent acute coronary events. We investigated intravascular ultrasound (IVUS) and near-infrared spectroscopy (NIRS) characteristics of lesions that were histopathologic TCFAs. IVUS, NIRS, and histopathology were performed in 271 atherosclerotic lesions from 107 fresh coronary arteries from 54 patients at necropsy. The plaque burden and remodeling index calculated by IVUS and maximum lipid core burden index within any 4-mm segment (maxLCBI
4mm ) calculated by NIRS were compared among each plaque type based on histopathologic classifications but focusing on TCFA. Lesions classified as TCFAs had the largest plaque burden, the highest remodeling index, and the greatest maxLCBI4mm . Plaque burden ≥69% (90% sensitivity, 75% specificity, and area under the curve 0.87); remodeling index ≥1.07 (80% sensitivity, 79% specificity, and area under the curve 0.84); and maxLCBI4mm ≥323 (80% sensitivity, 85% specificity, and area under the curve 0.84) predicted a histopathologic TCFA. In conclusion, a large plaque burden and a high remodeling index assessed by IVUS and lipid-rich plaque determined by the NIRS maxLCBI4mm are useful predictive markers of TCFA., (Copyright © 2016 Elsevier Inc. All rights reserved.)- Published
- 2017
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5. Relationship Between Platelet Reactivity and Culprit Lesion Morphology: An Assessment From the ADAPT-DES Intravascular Ultrasound Substudy.
- Author
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Yun KH, Mintz GS, Witzenbichler B, Inaba S, Shimizu T, Metzger DC, Rinaldi MJ, Mazzaferri EL Jr, Duffy PL, Weisz G, Stuckey TD, Brodie BR, Kirtane AJ, Stone GW, and Maehara A
- Subjects
- Aged, Chi-Square Distribution, Clopidogrel, Coronary Artery Disease blood, Coronary Artery Disease diagnostic imaging, Drug Resistance, Drug-Eluting Stents, Female, Fibrosis, Germany, Humans, Least-Squares Analysis, Logistic Models, Male, Middle Aged, Multivariate Analysis, Plaque, Atherosclerotic, Platelet Aggregation Inhibitors adverse effects, Platelet Function Tests, Predictive Value of Tests, Prospective Studies, Risk Factors, Ticlopidine adverse effects, Ticlopidine therapeutic use, Time Factors, Treatment Outcome, United States, Coronary Artery Disease therapy, Coronary Vessels diagnostic imaging, Percutaneous Coronary Intervention adverse effects, Percutaneous Coronary Intervention instrumentation, Platelet Aggregation drug effects, Platelet Aggregation Inhibitors therapeutic use, Ticlopidine analogs & derivatives, Ultrasonography, Interventional
- Abstract
Objectives: This study evaluated the relationship between platelet reactivity and plaque morphology using grayscale and radiofrequency intravascular ultrasound (IVUS) virtual histology (VH)., Background: Recent studies have reported that high on-treatment platelet reactivity (HPR) is associated with higher plaque volume and the presence of multivessel disease; however, the association between HPR and plaque morphology has not been evaluated., Methods: The ADAPT-DES (Dual AntiPlatelet Therapy With Drug Eluting Stents) intravascular ultrasound substudy was a prospective, multicenter, observational study of 8,582 patients undergoing percutaneous coronary intervention with drug-eluting stents in whom platelet reactivity on clopidogrel was assessed routinely. The current analysis included 909 culprit lesions from 773 patients with pre-intervention grayscale IVUS and IVUS-VH. HPR was defined as platelet reactivity >208 P2Y12 reaction unit in point-of-care P2Y12 testing by the VerifyNow assay, measured during steady-state platelet inhibition in patients receiving an antiplatelet agent., Results: HPR was associated with 3-vessel coronary artery disease (31.0% vs. 24.4%; p = 0.04). The incidence of fibroatheroma was higher in patients with HPR than those without HPR (77.1% vs. 68.9%; p = 0.01). The HPR group had larger percent plaque and media volume (plaque and media/external elastic membrane volume: 58.1% [95% confidence interval (CI): 57.1% to 59.0%] vs. 56.6% [95% CI: 55.8% to 57.5%]; p = 0.03) and plaque burden at the minimum lumen site (76.7% [95% CI: 75.7% to 77.8%] vs. 75.0% [95% CI: 74.0% to 76.0%]; p = 0.02). Despite a similar prevalence of attenuated plaque, patients with HPR had longer culprit lesion attenuated plaque length (8.0 [95% CI: 7.0 to 9.1] mm vs. 6.5 [95% CI: 5.9 to 7.1] mm; p = 0.01). On multivariate analysis, the presence of angiographic calcium (odds ratio [OR]: 1.85: 95% CI: 1.33 to 2.56; p = 0.0002) and HPR (OR: 1.45; 95% CI: 1.05 to 2.01; p = 0.02) were independent predictors for a culprit lesion fibroatheroma., Conclusions: HPR was associated with increased culprit lesion atherosclerotic burden and adverse plaque morphology among patients undergoing percutaneous coronary intervention. Platelet reactivity might be associated with not only blood clot formation, but also severity of atherosclerosis. (Assessment of Dual AntiPlatelet Therapy With Drug Eluting Stents [ADAPT-DES]; NCT00638794)., (Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
- Published
- 2016
- Full Text
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6. Differences in Underlying Culprit Lesion Morphology Between Men and Women: An IVUS Analysis From the ADAPT-DES Study.
- Author
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Wang L, Mintz GS, Witzenbichler B, Metzger DC, Rinaldi MJ, Duffy PL, Weisz G, Stuckey TD, Brodie BR, Inaba S, Xu K, Kirtane AJ, Stone GW, and Maehara A
- Subjects
- Aged, Coronary Artery Disease therapy, Female, Humans, Male, Middle Aged, Predictive Value of Tests, Prognosis, Risk Factors, Rupture, Spontaneous, Severity of Illness Index, Sex Factors, Coronary Artery Disease diagnostic imaging, Coronary Vessels diagnostic imaging, Health Status Disparities, Plaque, Atherosclerotic, Ultrasonography, Interventional
- Published
- 2016
- Full Text
- View/download PDF
7. Acute closure due to extramedial hematoma 3 hours after stenting.
- Author
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Inaba S, Mintz GS, Collins MB, Fall KN, Moses JW, and Maehara A
- Subjects
- Coronary Angiography, Coronary Restenosis diagnosis, Coronary Stenosis diagnosis, Coronary Stenosis surgery, Coronary Vessels diagnostic imaging, Coronary Vessels pathology, Diagnosis, Differential, Female, Follow-Up Studies, Hematoma diagnosis, Humans, Middle Aged, Time Factors, Tomography, Optical Coherence, Ultrasonography, Interventional, Coronary Restenosis etiology, Coronary Vessels surgery, Hematoma complications, Myocardium pathology, Postoperative Complications, Stents adverse effects
- Published
- 2014
- Full Text
- View/download PDF
8. Compensatory enlargement of the left main coronary artery: insights from the PROSPECT study.
- Author
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Inaba S, Mintz GS, Shimizu T, Weisz G, Mehran R, Marso SP, Xu K, de Bruyne B, Serruys PW, Stone GW, and Maehara A
- Subjects
- Aged, Coronary Artery Disease therapy, Disease Progression, Female, Humans, Male, Middle Aged, Percutaneous Coronary Intervention, Phenotype, Predictive Value of Tests, Treatment Outcome, Ultrasonography, Interventional, Coronary Artery Disease diagnostic imaging, Coronary Vessels diagnostic imaging, Plaque, Atherosclerotic
- Abstract
Objectives: Glagov proposed that remodeling delayed development of significant coronary artery stenoses until plaque occupied, on average, 40% of arterial area (40% plaque burden). The aim of the current study was to confirm the previously proposed concept of coronary remodeling as first described by Glagov who studied postmortem left main coronary arteries (LMCAs)., Methods: Using the in-vivo intravascular ultrasound data from the Providing Regional Observations to Study Predictors of Events in the Coronary Tree (PROSPECT) study, we evaluated 552 LMCAs in 552 patients., Results: External elastic membrane cross-sectional areas (CSAs) increased in proportion to the increase in plaque and media CSAs (r=0.61, P<0.0001), especially when the plaque burden was 20% or lower (r=0.88, P<0.0001). For more advanced atherosclerosis (>40% plaque burden), there was an inverse relationship between lumen CSA and plaque burden (r=-0.57, P<0.0001), whereas this relationship was weak in the presence of less than 40% plaque burden. The frequency of virtual histology derived thin-cap fibroatheroma increased with increasing plaque burden. In contrast, the frequency of pathological intimal thickening decreased., Conclusion: The previously proposed remodeling concept of Glagov was validated in vivo in the PROSPECT study patients. In addition, the present study suggested that plaque phenotype worsened with increasing LMCA plaque growth.
- Published
- 2014
- Full Text
- View/download PDF
9. Impact of positive and negative lesion site remodeling on clinical outcomes: insights from PROSPECT.
- Author
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Inaba S, Mintz GS, Farhat NZ, Fajadet J, Dudek D, Marzocchi A, Templin B, Weisz G, Xu K, de Bruyne B, Serruys PW, Stone GW, and Maehara A
- Subjects
- Aged, Angioplasty, Balloon, Coronary, Coronary Artery Disease mortality, Coronary Artery Disease therapy, Female, Follow-Up Studies, Global Health, Humans, Male, Middle Aged, Predictive Value of Tests, Prognosis, Prospective Studies, ROC Curve, Severity of Illness Index, Survival Rate trends, Time Factors, Ultrasonography, Interventional, Coronary Artery Disease diagnosis, Coronary Vessels physiopathology, Risk Assessment
- Abstract
Objectives: This study investigated coronary artery remodeling patterns associated with clinical outcomes., Background: In the prospective, multicenter PROSPECT (Providing Regional Observations to Study Predictors of Events in the Coronary Tree: An Imaging Study in Patients With Unstable Atherosclerotic Lesions) study, reported predictors of nonculprit lesion (NCL) major adverse cardiac events (MACE) were an intravascular ultrasound (IVUS) minimal lumen area (MLA) ≤4 mm(2), a plaque burden ≥70%, and a IVUS-virtual histology (VH) thin-cap fibroatheroma (TCFA), but not lesion site remodeling., Methods: Overall, 697 consecutive patients with an acute coronary syndrome were enrolled and underwent 3-vessel gray-scale and IVUS-VH; 3,223 NCLs were identified by IVUS. The remodeling index (RI) was calculated as the external elastic membrane area at the MLA site divided by the average of the proximal and distal reference external elastic membrane areas. First, one third of the patients were randomly selected to determine RI cutoffs related to NCL MACE (development cohort). Receiver-operating characteristic analysis showed that there were 2 separate cut points that predicted NCL MACE: RI = 0.8789 and RI = 1.0046 (area under the curve = 0.663). These cut points were used to define negative remodeling as an RI <0.88, intermediate remodeling as an RI of 0.88 to 1.00, and positive remodeling as an RI >1.00. Second, we used the remaining two-thirds of patients to validate these cut points with respect to lesion morphology and clinical outcomes (validation cohort)., Results: Kaplan-Meier curve analysis in the validation cohort showed that NCL MACE occurred more frequent (and equally) in negative and positive remodeling lesions compared with intermediate remodeling lesions. In this cohort, negative remodeling lesions had the smallest MLA, positive remodeling lesions had the largest plaque burden, and VH TCFA, especially VH TCFA with multiple necrotic cores, was most common in negatively remodeling lesions., Conclusions: The present study showed the novel concept that positive and negative lesion site remodeling was associated with unanticipated NCL MACE in the PROSPECT study. (, Prospect: An Imaging Study in Patients With Unstable Atherosclerotic Lesions [PROSPECT]; NCT00180466)., (Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
- Published
- 2014
- Full Text
- View/download PDF
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