Mechanical and Pharmacological Revascularization Strategies for Prevention of Microvascular Dysfunction in ST-Segment Elevation Myocardial Infarction: Analysis from Index of Microcirculatory Resistance Registry Data

Jang, Ji-Hoon; Lee, Man−Jong; Ko, Kyu-Yong; Park, Jin Hee; Baek, Yoon Su; Kwon, Sung‐Woo; Shin, Sung‐Hee; Woo, Seong‐Ill; Kim, Dae Hyeok; Suh, Young Ju; Kwan, Jun; Park, Sang‐Don

doi:10.1155/2020/5036396

Cited by 7 publications

(6 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In their study, Khan et al showed that microvascular injury was more reduced in the third-generation P2Y 12 inhibitor group. Results published by Jang et al support the claim that third-generation P2Y 12 inhibitors are more effective in lowering the IMR value than clopidogrel in patients with STEMI [ 45 ].…”

Section: Discussionmentioning

confidence: 69%

Aspiration Thrombectomy in Patients with Acute Myocardial Infarction—5-Year Analysis Based on a Large National Registry (ORPKI)

Januszek

Siudak

Malinowski

et al. 2020

JCM

View full text Add to dashboard Cite

Blood flow restoration after primary percutaneous coronary intervention (pPCI) in patients with acute myocardial infarction (AMI) may not always be achieved and could be complicated by the no-reflow phenomenon (NRP). The aim of the current study was to assess the frequency of thrombus aspirations (TAs) and NRPs in patients with AMI and treated with pPCI based on the data collected during a 5-year period in the national ORPKI registry, as well as the frequency of periprocedural strokes and predictors of TA and NRP. This retrospective analysis was performed on prospectively collected data gathered in the Polish National Registry of Percutaneous Coronary Interventions (ORPKI), which covered the period between January 2014 and December 2018, and included 200,991 patients treated due to AMI out of 535,857 patients treated using PCI. Among them, 16,777 patients underwent TA. TA was mainly used in the STEMI subgroup of 14,207 patients (84.8%). The frequency of NRP among AMI patients in the thrombectomy group was 2.75% and in the non-thrombectomy group 0.82%. Predictors of TA and NRP were also assessed using multivariate analysis. The percentage of patients treated with pPCI and with PCI alone increased significantly in all of the three selected groups of patients from 88.7% to 94.3% in the AMI group (p < 0.001), from 82.3% to 90.3% in the STEMI subgroup (p < 0.001), and from 96.3% to 98.2% in the NSTEMI subgroup (p < 0.001) during the analysed period. NRP occurred more often in the thrombectomy group for the NSTEMI (0.58% vs. 3.07%, p < 0.05) and STEMI (1.06% vs. 2.69%, p < 0.05) subgroups. Periprocedural stroke occurred more often in the thrombectomy group in comparison to the non-thrombectomy group with AMI (0.03% vs. 0.01%, p < 0.05) and the NSTEMI (0.16% vs. 0.02%, p < 0.05). In conclusion, the frequency of TA has been experiencing a steady decline in recent years, regardless of AMI type, among patients treated with pPCI.

show abstract

Section: Discussionmentioning

confidence: 69%

Aspiration Thrombectomy in Patients with Acute Myocardial Infarction—5-Year Analysis Based on a Large National Registry (ORPKI)

Januszek

Siudak

Malinowski

et al. 2020

JCM

View full text Add to dashboard Cite

show abstract

“…Prolonged contrast elution has been considered a classic angiographic marker of coronary microvascular damage, introducing the concept of TMPG. 23 Jang et al 28 conducted a study evaluating coronary microvascular dysfunction in patients with STEMI and found that TMPG was more sensitive than TIMI for screening out microvascular dysfunction. Jia et al 29 adopted TMPG of the intervened vessel to evaluate the benefits of high-dose statins on improving coronary microcirculation in patients with ACS.…”

Section: Discussionmentioning

confidence: 99%

“…23 Jang et al. 28 conducted a study evaluating coronary microvascular dysfunction in patients with STEMI and found that TMPG was more sensitive than TIMI for screening out microvascular dysfunction. Jia et al.…”

Section: Discussionmentioning

confidence: 99%

Effects of atorvastatin and rosuvastatin on dysfunctional coronary circulation in patients with ST-segment elevation myocardial infarction

Zhou

Zhang

et al. 2023

J Int Med Res

View full text Add to dashboard Cite

Objective Evidence of therapy for dysfunctional coronary circulation in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI) is limited. This study was performed to compare the effects of atorvastatin and rosuvastatin on dysfunctional coronary circulation. Methods This retrospective study enrolled 597 consecutive patients with STEMI who underwent pPCI in 3 centers from June 2016 to December 2019. Dysfunctional coronary circulation was defined by the thrombolysis in myocardial infarction (TIMI) grade and the TIMI myocardial perfusion grade (TMPG). Logistic regression analysis was used to evaluate the impact of different statin types on dysfunctional coronary circulation. Results The incidence of TIMI no/slow reflow did not differ between the two groups, but the incidence of TMPG no/slow reflow was significantly lower in the atorvastatin than rosuvastatin group (44.58% vs. 57.69%, respectively). After multivariate adjustment, the odds ratio with 95% confidence interval of rosuvastatin was 1.72 (1.17–2.52) for after pretreatment TMPG no/slow reflow and 1.73 (1.16–2.58) for after stenting TMPG no/slow reflow. Atorvastatin and rosuvastatin showed no significant differences in clinical outcomes during hospitalization. Conclusions Compared with rosuvastatin, atorvastatin was associated with better coronary microcirculatory perfusion in patients with STEMI who underwent pPCI.

show abstract

“… 31 Jang and De Luca et al found that high Killip grade was associated with a high coronary microcirculation resistance index and myocardial reperfusion injury. 32 , 33 …”

Section: Discussionmentioning

confidence: 99%

Development and Validation of a Clinical and Laboratory-Based Nomogram for Predicting Coronary Microvascular Obstruction in NSTEMI Patients After Primary PCI

T¹,

Wang²,

Wang³

et al. 2022

TCRM

View full text Add to dashboard Cite

Objective Cardiac microvascular obstruction (CMVO) remains a severe complication in non-ST elevation myocardial infarction (NSTEMI) patients with reperfusion therapy. We aimed at developing and validating the nomogram to predict the possibility of CMVO after primary percutaneous coronary intervention (PCI) by integrating clinical and laboratory-based information. Methods A total of 325 patients undergoing primary PCI for NSTEMI were recruited and divided into the training cohort (n=226) and the validating cohort (n = 99). The development of the nomogram was based on independent predictors of CMVO, and these variables were selected by multivariable logistic regression analysis. Results Independent predictors contained in nomogram were identified by multivariable logistic regression analysis, and these independent predictors included neutrophils (OR 1.166, 95% CI 1.044–1.303, P <0.01), hemoglobin (OR 1.037, 95% CI 1.013–1.062, P <0.01), triglyceride (OR 1.343, 95% CI 1.059; 1.704, P =0.015), Killip grade (OR 2.190, 95% CI 1.065–4.503, P =0.033), high thrombus load (OR 3.146, 95% CI 1.424–6.952, P <0.01), no-reflow (OR 3.142, 95% CI 1.419–6.955, P <0.01) and ischemic postconditioning (OR 0.445, 95% CI 0.209–0.944, P =0.035). The nomogram accurately predicted the presentation of CMVO in both the training set and validating set (AUC, 0.835 and 0.881, respectively). The results predicted by nomogram were confirmed to be highly consistent with the results of DE-CMR, both the training and validating cohorts, by Calibration plot and Hosmer-Lemeshow test. Decision curve analysis (DCA) also suggested that the nomogram was applicable in the clinic. Conclusion The nomogram showed good performance in predicting CMVO, and it could help clinicians optimize the clinical treatments to improve the prognosis of NSTEMI patients.

show abstract

Mechanical and Pharmacological Revascularization Strategies for Prevention of Microvascular Dysfunction in ST-Segment Elevation Myocardial Infarction: Analysis from Index of Microcirculatory Resistance Registry Data

Cited by 7 publications

References 38 publications

Aspiration Thrombectomy in Patients with Acute Myocardial Infarction—5-Year Analysis Based on a Large National Registry (ORPKI)

Aspiration Thrombectomy in Patients with Acute Myocardial Infarction—5-Year Analysis Based on a Large National Registry (ORPKI)

Effects of atorvastatin and rosuvastatin on dysfunctional coronary circulation in patients with ST-segment elevation myocardial infarction

Development and Validation of a Clinical and Laboratory-Based Nomogram for Predicting Coronary Microvascular Obstruction in NSTEMI Patients After Primary PCI

Contact Info

Product

Resources

About