Angiographic findings and catheterization laboratory events in patients with primary coronary angioplasty or streptokinase therapy for acute myocardial infarction

Abstract

Primary coronary angioplasty is a highly effective and safe reperfusion modality for patients with acute myocardial infarction. However, TIMI grade 2 flow through the infarct-related vessel immediately after angioplasty is a predictor of reocclusion.

Transferring patients for primary angioplasty: a retrospective analysis of 104 selected high risk patients with acute myocardial infarction

“…Of the patients who presented directly to our hospital, 87% participated in one of our trials 12 4 6 Thrombolytic treatment was given to 205 patients and 520 were candidates for primary angioplasty. Of these 520 patients, 416 presented directly to our hospital, and 104 were initially admitted to another hospital without a catheterisation laboratory or angioplasty expertise and were transferred by ambulance for immediate angiography with a view to primary angioplasty after an initial diagnosis of acute myocardial infarction had been made at the local facility.…”

Reduced collateral circulation to the infarct-related artery in elderly patients with acute myocardial infarction

“…It is estimated that collateral circulation to infarct-related artery (IRA) is present in almost 40% of patients with acute myocardial infarction (AMI) in the acute phase (1,2). Collateral circulations exert beneficial effects by increasing myocardial salvage (3)(4)(5) and preventing ventricular remodeling (6), thereby improving in-hospital prognosis (7).…”

The Human Myocardial Stain as Mitigated by Coronary Collaterals

“…Previous investigations have observed collateral vessels at the onset of acute myocardial infarction in ≈40% of patients. 11 Waldecker et al 12 detected angiographic collaterals to myocardium distal to an acutely occluded coronary artery in 334 (53%) of 626 patients during the acute infarct phase, whereas the prevalence was shown to increase between 3 and 6 hours after symptom onset (from 66% to 75%), and the absence of collaterals was related to the early occurrence of cardiogenic shock. Collaterals that develop late after infarction into an area of necrotic myocardial tissue may exert a beneficial effect on LV dilatation or aneurysm expansion.…”