Measurement of microvascular function in patients presenting with thrombolysis for ST elevation myocardial infarction, and PCI for non-ST elevation myocardial infarction

Autor: C. Judkins, Robert Whitbourn, Jamie Layland, Paul D. Williams, H. Adams, Andrew T. Burns, Andrew Wilson, Andre La Gerche, Andrew I. MacIsaac, Sonny Palmer, Srikkumar Ashokkumar
Rok vydání: 2018
Předmět:
Male
Acute coronary syndrome
medicine.medical_specialty
Cardiac Catheterization
medicine.medical_treatment
Heart Ventricles
Population
030204 cardiovascular system & hematology
Ventricular Function
Left
03 medical and health sciences
0302 clinical medicine
Percutaneous Coronary Intervention
Internal medicine
Coronary Circulation
medicine
Humans
Thrombolytic Therapy
cardiovascular diseases
030212 general & internal medicine
Prospective Studies
education
Non-ST Elevated Myocardial Infarction
Cardiac catheterization
education.field_of_study
Ejection fraction
Aspirin
business.industry
Microcirculation
Percutaneous coronary intervention
General Medicine
Thrombolysis
Middle Aged
medicine.disease
Coronary Vessels
Clopidogrel
surgical procedures
operative
Treatment Outcome
Echocardiography
Conventional PCI
Cardiology
Platelet aggregation inhibitor
ST Elevation Myocardial Infarction
Female
Vascular Resistance
Cardiology and Cardiovascular Medicine
business
Platelet Aggregation Inhibitors
Zdroj: Cardiovascular revascularization medicine : including molecular interventions. 19(8)
ISSN: 1878-0938
Popis: Background In this prospective study, we compared the invasive measures of microvascular function in two subsets: patients with pharmacoinvasive thrombolysis for STEMI, and patients undergoing percutaneous coronary intervention (PCI) for NSTEMI. Methods The study consisted of 17 patients with STEMI referred for cardiac catheterisation post thrombolysis, and 20 patients with NSTEMI. Coronary physiological indexes were measured in each patient before and after PCI. Results The median pre-PCI index of microcirculatory function (IMR) at baseline was significantly higher in the STEMI group than the NSTEMI group (26 units vs. 15 units, p = 0.02). Following PCI, IMR decreased in both groups (STEMI 20 units vs. NSTEMI 14 units, p = 0.10). There was an inverse correlation between post PCI IMR and left ventricular ejection fraction (LVEF) (r = −0.52, p = 0.001). Furthermore, post PCI IMR was an independent predictor of index admission LVEF in the total population (β = −0.388, p = 0.02). Conclusion Invasive measures of microvascular function are inferior in a pharmacoinvasive STEMI group compared to a clinically stable NSTEMI group. In the STEMI population, the IMR following coronary intervention appears to predict LVEF.
Databáze: OpenAIRE
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