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논문번호 292
논문제목(영문) Staged Spasm Provocation Test Without Coronary Stenting in a Patient Presenting With ST-Segment Elevation Myocardial Infarction.
국내외구분 국내 SCI여부 KCI
연구책임자역할 공저자
주저자명 Cho KH
교신저자명 Hong YJ
공동저자명 Kim MC, Sim DS, Kim JH, Ahn Y, Jeong MH
게제년월일 2022-06-01
ISSN 2799-6999
Impact Factor 0
학술지명 J Cardiovasc Interv
서지사항 0집 / 1권 / 2호,   페이지(90 - 95)
요약초록문
(Abstract) 입력		 Plaque erosion is a major cause of acute coronary thrombosis. This might be due to a combination of several factors, including endothelial, fluid dynamics, systemic, and vasomotion factors, and spasm. However, the extent to which vasospasm contributes to the development of plaque erosion in patients with acute coronar y syndrome is unclear. We present an educational case of an ST-segment elevation myocardial infarction, successfully managed medically under the guidance of intracoronar y optical coherence tomography (OCT) and staged vasospasm provocation test. A 53-year-old male presented with acute chest pain associated with inferior-lead ST-segment elevation. After immediately arriving at our hospital, ventricular fibrillation occurred, followed by defibrillation. Emergency coronary angiography (CAG) revealed moderate to severe stenosis of the middle right coronar y artery. OCT demonstrated intraluminal thrombi without definitive plaque rupture, suggesting plaque erosion. After 3 days, we performed an ergonovine provocation test that revealed near-total occlusion in the previous stenotic site of the right coronar y arter y at a low level of intracoronar y ergonovine of 10 mg. OCT revealed resolved thrombi with an intact fibrous cap. The minimal lumen area was 3.65 mm2. After the patient-physician discussion, we decided to treat the lesion medically. After 6 months, CAG revealed no significant inter val changes compared to the previous examination. After 12 months, he was free of chest symptoms and cardiovascular events. The staged spasm provocation test may be beneficial for the proper management of selected patients with acute coronary thrombus in whom OCT demonstrates plaque erosion at the culprit lesion.
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