Cardioprotection for Acute MI in Light of the CONDI2/ERIC-PPCI Trial: New Targets Needed

Giblett, Joel P.; Bulluck, Heerajnarain

doi:10.15420/icr.2020.01

Cited by 3 publications

(2 citation statements)

References 86 publications

(109 reference statements)

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“…A prior study using Troponin T showed similar findings as our current study with higher levels in those with poor coronary collaterals. 15,17 Studies by klopfer et al 19 and Habib et al 20 were also on similar lines.…”

Section: Discussionmentioning

confidence: 56%

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Does the extent of collaterals influence the severity of the myocardial injury as assessed by elevation in biomarkers?

Dubey

Sharma

Patel

et al. 2021

J Cardiovasc Thorac Res

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Introduction: Quantitative analysis of cardiac biomarkers, troponin I and CPK-MB, estimates the extent of myocardial injury while extent of benefit from coronary collateral circulation (CCC) to protect myocardium during acute myocardial infarction (AMI) needs validation. We analysed if the extent of collaterals had impact on baseline biomarkers at the time of coronary angiogram. Methods: We analysed 3616 consecutive patients who presented with AMI and underwent invasive coronary angiography (CAG) with intent to revascularisation with biomarkers assessment at the time of CAG. CCC to Infarct related artery (IRA) were graded as per Rentrop grading viz. poorly-developed CCC (Grade 0/1 as Group A) and well-developed CCC (Grade 2/3 as Group B). Results: Both groups (A and B) were matched for demographics, traditional risk factors, SYNTAX 1 Score, time to CAG from onset of angina and eGFR. 36.59% of patients had Non-ST segment elevation myocardial infarction (NSTEMI) as compared to 63.41% ST -segment elevation infarction (STEMI). Overall Troponin I (P=0.01, P=0.01) and CPK MB (P=0.00, P=0.002) values were lower in group B in both NSTEMI and STEMI groups respectively. Troponin I and CPK-MB were significantly lower in group B [with NSTEMI for SVD (Single vessel disease) (P=0.05) and DVD (Double vessel disease) (P=0.04),but not for TVD (Triple vessel disease) and with STEMI in SVD (P=0.01), DVD (P=0.01) and TVD (P=0.001)]. Conclusion: Patients with well-developed coronary collaterals had a lower rise in biomarkers in AMI as compared to those with poor collaterals amongst both NSTEMI and STEMI groups.

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Section: Discussionmentioning

confidence: 56%

“…9,13,14 In fact, the biomarker value decreases as the collateral grade increases. 15,16,17 Our study is unique for analysing biomarkers sample being drawn at the time of angiogram. The study has given new insights into the impact of well-developed collaterals on traditional biomarker values in AMI patients in Asian Indian population.…”

Section: Discussionmentioning

confidence: 99%

Does the extent of collaterals influence the severity of the myocardial injury as assessed by elevation in biomarkers?

Dubey

Sharma

Patel

et al. 2021

J Cardiovasc Thorac Res

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Coronary Heart Disease and Myocardial Ischemia

Groh

Dhein

Salameh

2022

Comprehensive Pharmacology

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Evaluation of Clinical Efficiency of Cardioprotective Therapy in Patients with Acute Myocardial Infarction

Astrakhantseva¹,

Vorobyov²,

Nikolayev

et al. 2021

Neotložnaâ med. pomoŝʹ

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Aim. To evaluate the efficiency of cardioprotective therapy using intravenous metoprolol in combination with a high dose of atorvastatin in the prevention of myocardial remodeling (MR) and heart failure (HF) in patients with acute ST-segment elevation myocardial infarction (STEMI).Material AND methods. A prospective study included 100 STEMI patients who underwent primary percutaneous intervention (PCI). Depending on the regimens of drug cardioprotection, three groups of patients were formed: the first (2014–2015) — 34 patients who received 80 mg atorvastatin as a part of the basic therapy on the first day of STEMI, then 20–40 mg/day for 30 days. The second group (2017–2018) — 34 patients who received atorvastatin 80 mg/day for a month from the onset of STEMI. The third group (2018–2019) — 32 patients who received intravenous metoprolol tartrate (5–15 mg) and atorvastatin 80 mg/day before PCI for a month from the onset of STEMI. On days 1 and 2 of STEMI and one month later, patients were assessed for serum levels of cardiac biomarkers; on the 1st, 7th days and one month later, echocardiographic studies (EchoCG) were performed. At the end of the observation, clinical and imaging outcomes (MR and HF) were assessed, which were compared with the dynamics of biomarkers between the groups of patients.Results. The combined use of atorvastatin 80 mg/day for a month from the onset of STEMI and a single intravenous injection of metoprolol tartrate (5–15 mg) in the acute phase of STEMI before PCI showed the most significant effects in the prevention of the development of structural and functional myocardial disorders and clinically severe heart failure, and also caused the minimal serum activity of cardiomarkers in the third group of patients in comparison with the first and second groups of patients without this drug combination. Also, correlations between biomarkers and echocardiography indicators were established in the third group of patients who received cardioprotective therapy.Conclusion. The combined use of high-dose atorvastatin for a month with a single intravenous injection of metoprolol tartrate in acute STEMI before PCI prevents the formation of MR and clinically significant HF in the post-infarction period. Comprehensive dynamic assessment of cardiac biomarkers and echocardiography parameters within a month after post-STEMI is a highly informative tools for monitoring the efficiency of cardioprotective therapy.

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Cardioprotection for Acute MI in Light of the CONDI2/ERIC-PPCI Trial: New Targets Needed

Cited by 3 publications

References 86 publications

Does the extent of collaterals influence the severity of the myocardial injury as assessed by elevation in biomarkers?

Does the extent of collaterals influence the severity of the myocardial injury as assessed by elevation in biomarkers?

Coronary Heart Disease and Myocardial Ischemia

Evaluation of Clinical Efficiency of Cardioprotective Therapy in Patients with Acute Myocardial Infarction

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