Effect of Aspiration Thrombectomy on Microvascular Dysfunction in ST-Segment Elevation Myocardial Infarction With an Elevated Neutrophil Count
| Autor: | Hyo Seung Ahn, Yoon Jung Kang, Byung Ok Kim, Choong Won Goh, Mee Won Hwang, Hyeyoung Lee, Kun Joo Rhee, Kyoung-Min Park, Young Sup Byun, Jeong Hoon Kim |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2011 |
| Předmět: |
medicine.medical_specialty
business.industry Neutrophils medicine.medical_treatment Percutaneous coronary intervention Thrombolysis medicine.disease Surgery Myocardial infarction surgical procedures operative Internal medicine Conventional PCI Internal Medicine medicine Absolute neutrophil count Cardiology ST segment Original Article cardiovascular diseases Cardiology and Cardiovascular Medicine business Mace TIMI |
| Zdroj: | Korean Circulation Journal |
| ISSN: | 1738-5555 1738-5520 |
| Popis: | Background and Objectives: Aspiration thrombectomy (AT) during primary percutaneous coronary intervention (PCI) is an effective adjunctive therapy for ST-segment elevation myocardial infarction (STEMI). An elevated neutrophil count in STE MI is associated with microvascular dysfunction and adverse outcomes. We evaluated whether AT can improve microvascular dysfunction in patients with STEMI and an elevated neutrophil count. Subjects and Methods: Seventy patients with STEMI undergoing primary PCI from August 2007 to February 2009 in our institution were classified by tertiles of neutro phil count on admission ( 7,600/mm 3 ). The angiographic outcome was post-procedur al thrombolysis in myocardial infarction (TIMI) flow grade. Microvascular dysfunction was assessed by TIMI myocardial perfusion (TMP) grade and ST-segment resolution on electrocardiography 90 minutes after PCI. The clinical outcome was ma jor adverse cardiac event (MACE), defined as cardiac death, re-infarction, and target lesion revascularization at 9 months. Results: There were no significant differences in the clinical characteristics and pre- and post-procedural TIMI flow grades be tween the neutrophil tertiles. As the neutrophil count increased, a lower tendency toward TMP grade 3 (83% vs. 52% vs. 54%, p=0.06) and more persistent residual ST-segment elevation (>4 mm: 13% vs. 26% vs. 58%, p=0.005) was observed. The 9-month MACE rate was similar between the groups. On subgroup analysis of AT patients (n=52) classified by neutrophil tertiles, the same tendency toward less frequent TMP grade 3 (77% vs. 56% vs. 47%, p=0.06) and persistent residual ST-segment elevation (>4 mm: 12% vs. 28% vs. 53%, p=0.05) was observed as neutrophil count increased. Conclusion: A higher neutrophil count at presentation in STEMI is associated with more severe microvascular dysfunction after primary PCI, which is not improved with AT. (Korean Circ J 2011;41:68-75) |
| Databáze: | OpenAIRE |
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