Angiographic Morphologic Features of Infarct-Related Arteries and Timely Reperfusion in Acute Myocardial Infarction

Yip, Hon‐Kan; Chen, Mien‐Cheng; Chang, Hsueh‐Wen; Hang, Chi‐Ling; Hsieh, Yao‐Ching; Fang, Chih-Yuan; Wu, Chiung‐Jen

doi:10.1378/chest.122.4.1322

Cited by 272 publications

(244 citation statements)

References 26 publications

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“…The results were consistent with previous studies evaluated predictors of TIMI 2 in patients with acute ST segment elevation myocardial infarction (STEMI) undergoing primary PCI. 6,15 Our study also demonstrated that statin was also an independent predictor for the no-reflow, which was consistent with the report of Iwakura. 16…”

Section: Predictors Of No-reflowsupporting

confidence: 92%

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Chronic pretreatment of ACEI reduces no‐reflow in patients with acute myocardial infarction treated with primary angioplasty

Zhao

Yang

Zhang

et al. 2007

Clinical Cardiology

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SummaryBackground: In animal models, pretreatment with angiotensin-converting enzyme inhibitor (ACEI) can reduce no-reflow. In the present study, we investigated whether pretreatment with ACEI may prevent no-reflow in patients who underwent primary coronary intervention for AMI.Method and Results: A total of 259 consecutive patients who underwent primary angioplasty for a first AMI were studied. No-reflow was defined as a TIMI flow grade <3. The no-reflow phenomenon was found in 33 of 259 patients. There were no significant differences in clinical characteristics between the patients with and without ACEI pretreatment. However, the 47 patients receiving chronic ACEI treatment before admission had lower incidence of the no-reflow than those without it (4.2 and 14.6%, p < 0.05). Multivariable logistic regression analysis revealed that absence of ACEI pretreatment was a significant predictor of the no-reflow along with absence of preinfarction angina, complete occlusion of the culprit lesion, high-burden thrombus, ejection fraction on admission, number of Q-waves, absence of statin pretreatment, and anterior AMI.

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Section: Predictors Of No-reflowsupporting

confidence: 92%

“…High-burden thrombus was indicated according to the report by Yip. 6 After intracoronary injection of nitroglycerin, we performed coronary intervention with angioplasty by using appropriatesized balloon catheters. We repeated the angioplasty and implanted a stent.…”

Section: Study Protocolmentioning

confidence: 99%

Chronic pretreatment of ACEI reduces no‐reflow in patients with acute myocardial infarction treated with primary angioplasty

Zhao

Yang

Zhang

et al. 2007

Clinical Cardiology

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“…However, none was found to promptly and effectively restore the coronary flow. 10) Recently, administration of a platelet glycoprotein IIb/IIIa antagonist, abciximab, was reported to be able to enhance the fibrinolytic effect, change the thrombus architecture, and increase the coronary flow in vitro 11) and platelet activation was considered an underlying mechanism in patients with an acute myocardial infarction. Using quantitative myocardial contrast echocardiographic study, tirofiban also improved microvascular flow and reduced the infarct area after coronary occlusion/reperfusion in open-chest dogs.…”

Section: Discussionmentioning

confidence: 99%

Restoration of Normal Coronary Flow With Tirofiban by Intracoronary Administration for No-reflow Phenomenon After Stent Deployment

et al. 2005

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SUMMARYNo-reflow phenomenon is frequently observed during percutaneous coronary intervention in patients with acute coronary syndrome. It may jeopardize hemodynamic status or result in ischemic chest pain in these patients. Currently, there is no adequate solution for this problem. We report our experience with an acute coronary syndrome patient who developed no-reflow phenomenon associated with ST segment elevation and shock after percuteneous coronary balloon dilatation and stent deployment. Intracoronary administration of tirofiban immediately restored the coronary flow of the target vessel, and the disastrous condition reversed. Our experience suggests that intracoronary administration of tirofiban can be considered as an option in case of no-reflow phenomenon during percutaneous coronary intervention. (Int Heart J 2005; 46: 139-145)

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“…Definitions: STEMI was defined based on previous reports 2,3,10,22) as 1) typical chest pain lasting for more than 30 minutes with electrocardiogram identified ST-segment elevation > 1 mm in two consecutive precordial or inferior leads, 2) typical chest pain lasting for more than 30 minutes with a new onset of CLBBB. Procedural success was defined as a reduction to residual stenosis of < 20% by balloon angioplasty or successful stent deployment at the desired position with a residual stenosis < 10% followed by thrombolysis in myocardial infarction (TIMI) grade 3 flow in the infarct-related artery.…”

Section: )mentioning

confidence: 99%

“…Actually, the prevalence of multivessel disease (MVD) has been reported to be up to 40-65% in patients with AMI undergoing primary PCI. [7][8][9][10] This finding suggests that a significant proportion of these patients remain at increased risk of death and adverse outcomes even after receiving reperfusion therapy through thrombolysis or primary PCI for the infarctrelated artery (IRA). 8) Evidence-based medicine has demonstrated the additional benefit of complete revascularization by coronary artery bypass graft surgery in improving long-term clinical outcomes for unstable angina patients with MVD.…”

mentioning

confidence: 99%

Benefit of Revascularization in Non-Infarct-Related Artery in Multivessel Disease Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

et al. 2010

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SummaryThis study compared the prognosis of ST-elevation myocardial infarction (STEMI) in patients with multivessel disease (MVD) with that of single vessel disease (SVD) and investigated the revascularization benefit of noninfarct-related artery (IRA) in MVD patients undergoing primary percutaneous coronary intervention (PCI). Between 2002 and 2009, 1278 patients with STEMI underwent primary PCI. Of these patients, 717 (56.1%) with SVD (only IRA obstruction) were placed in group A, while 561 (43.9%) with MVD (Group B) were further categorized into group 1 (PCI for IRA) and group 2 (staged PCI for IRA+non-IRA). The results demonstrated a lower degree of successful reperfusion in IRA and higher 30-day and 1-year cumulative mortality rates in group B (P < 0.001). While there was no difference in successful reperfusion in IRA between group 1 and group 2, the 30-day and one-year cumulative mortality rates were higher in group 1. Multivariate analysis identified MVD as an independent predictor of 1-year mortality (P < 0.001). In conclusion, patients with subsequent PCI for MVD had better 30-day and 1-year outcomes than those with conservative treatment. (Int Heart J 2010; 51: 319-324)

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Angiographic Morphologic Features of Infarct-Related Arteries and Timely Reperfusion in Acute Myocardial Infarction

Cited by 272 publications

References 26 publications

Chronic pretreatment of ACEI reduces no‐reflow in patients with acute myocardial infarction treated with primary angioplasty

Chronic pretreatment of ACEI reduces no‐reflow in patients with acute myocardial infarction treated with primary angioplasty

Restoration of Normal Coronary Flow With Tirofiban by Intracoronary Administration for No-reflow Phenomenon After Stent Deployment

Benefit of Revascularization in Non-Infarct-Related Artery in Multivessel Disease Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

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