Background: There are few studies about the impact of diagonal branch blood flow on echocardiographic findings in patients with first acute anterior myocardial infarction undergoing primary angioplasty. Objectives: We aimed to compare left ventricular systolic function measures in patients with first acute anterior ST-segment elevation myocardial infarction (STEMI) treated with primary angioplasty based on diagonal branch blood flow after the procedure. Methods: This study was a single-center study that enrolled patients with their first acute anterior STEMI treated with primary angioplasty in our center between October 2020 and March 2021. Patients were divided into two groups: The patients with final thrombolysis in myocardial infarction (TIMI) flow III in diagonal (sufficient diagonal flow) and patients with final TIMI flow less than III in diagonal (insufficient diagonal flow) after the procedure. The left ventricular Wall-Motion Score Index (WMSI) and left ventricular ejection fraction (LVEF) were compared between the two groups. Results: A total of 107 patients with first anterior STEMI treated with primary PCI were enrolled in the present study, of which 13 patients (12.1%) had insufficient diagonal flow after primary coronary angioplasty. The LVEF was lower in patients with insufficient diagonal flow (32.92 ± 7.29% vs. 39 ± 8.68%, P = 0.018). Also, this group had higher LV WMSI (1.68 ± 0.28 vs. 1.49 ± 0.26, P = 0.029). Conclusions: The present study showed that in patients with first acute anterior STEMI undergoing primary angioplasty, insufficient diagonal branch flow after the procedure was associated with worse left ventricular systolic function and higher LV WMSI.

We discuss a young man with episodes of chest pain and dyspnea accompanied with transient T-wave inversion in precordial and inferior leads that repeated several times. Cardiovascular evaluation did not disclose any structural abnormality. Memory T wave following episodes of idiopathic left septal ventricular tachycardia was the reason of these changes and did not repeat after arrhythmia ablation.

Purpose: Due to the potential benefits of allopurinol in ischemic reperfusion injury, this randomized control trial was performed to evaluate the pretreatment allopurinol effect on major adverse cardiovascular events (MACE) in patients undergoing primary percutaneous coronary intervention (pPCI). Methods: A randomized controlled trial was performed on 170 first-time STEMI patients undergoing pPCI. Before the pPCI, patients in intervention group (n=85) received 300 mg dose of allopurinol and control group (n=85) received placebo. Then, for the next 28 days, 100 mg of allopurinol was given to allopurinol group and placebo to the other group. Patients were compared regarding the baseline characteristics, clinical findings and one-year MACE. Results: Our findings showed that patients receiving allopurinol had significantly longer door-to-balloon time than the control group (60.76 ± 19.38 vs. 50.06 ± 16.38 P-value: 0.001). During one year of follow-up, HF, CVA and mortality occurred more frequently in allopurinol group but differences were not statistically significant. No significant difference was also seen between the two groups regarding MACE during follow-up or hospitalization (p-value: 0.179, 0.330 respectively). Kaplan-Meier curve could not show a significant difference between the two groups in terms of mortality and MACE (P-value: 0.317 and 0.128 respectively). Conclusion: According to findings of this trial allopurinol had no cardioprotective effect against adverse cardiovascular events or death in patients undergoing pPCI.