A Combination of Plaque Components Analyzed by Integrated Backscatter Intravascular Ultrasound and Serum Pregnancy-Associated Plasma Protein A Levels Predict the No-Reflow Phenomenon During Percutaneous Coronary Intervention

AimsPrevious studies reported that integrated backscatter intravascular ultrasound (IB-IVUS) provides high diagnostic accuracy for tissue characterization of coronary plaques and that pregnancy-associated plasma protein A (PAPP-A) could be a marker of adverse cardiac outcome in patients with cardiovascular disease. We examined whether IB-IVUS and PAPP-A levels could predict the incidence of no-reflow during percutaneous coronary intervention (PCI) Methods and ResultsAbout 176 consecutive patients (138 men, mean age 6811 years) who underwent PCI with IB-IVUS were prospectively enrolled. Combined no-reflow, including transient filter no-reflow by using distal protection devices, was observed in 31 patients. The percentages of coronary lipid volume (%LV) analyzed by IB-IVUS and serum PAPP-A were significantly higher in patients with combined no-reflow than normal-reflow. To predict no-reflow, a receiver operating characteristic (ROC) analysis determined cut-off values of %LV as 62% and serum PAPP-A as 7.71 ng/mL. The multivariate logistic regression analysis showed that %LV (hazard ratio 4.5, 95% confidence interval 1.6-13.4, P<0.01) and PAPP-A (hazard ratio 4.32, 95% confidence interval 1.5-12.7, P<0.01) were independent predictors of combined no-reflow Conclusions%LV analyzed by IB-IVUS and serum PAPP-A levels were closely associated with the coronary no-reflow phenomenon. (c) 2014 Wiley Periodicals, Inc.