Microvascular obstruction in ST elevation myocardial infarction patients undergoing primary percutaneous coronary intervention: another frontier to conquer?

Elgendy, Islam Y.; Jneid, Hani

doi:10.21037/jtd.2018.03.58

Cited by 5 publications

(2 citation statements)

References 30 publications

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“…Genetic preponderance, ischemic injury, reperfusion injury and micro emboli have all been postulated as the causative mechanism for this dreaded complication. 9 In our study NRP occurred in every fourth patient i.e., 25% incidence. Different studies have put the incidence of NRP from 5-50%.…”

Section: Discussionsupporting

confidence: 50%

The Predictive Value of CHADS-VASC Score in No-Reflow Phenomenon in Primary Percutaneous Coronary Intervention

Farahe

Samore²,

Ali³

et al. 2022

PAFMJ

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Objectives: To determine the role of CHADS-VASc Score in predicting No Reflow phenomenon in STEMI patients undergoing primary PCI. Study Design: Analytical cross-sectional study. Place and Duration of Study: This study was carried out at a Tertiary Cardiac Care Center from Feb to May 2022. Methodology: A total of (n = 320) patients who underwent PPCI at Armed Forces Institute of Cardiology from 4th February to 3rd May 2022 were enrolled in this study. Patients were divided into 2 groups, Comparision group with no NRP and NRP group. Descriptive statistics was run to present the categorical data in frequencies and percentages and continuous data in Mean±SD. Chi square test was applied to compare both groups regarding categorical and continuous variables. CHADS-VASc score was also compared in both groups. Results: Out of (n=320) patients, 80(25%) patients developed NRP. Age, Diabetes, LV EF, history of stroke or TIA, peripheral arterial disease, TIMI thrombus grade, total stented length and CHADS-VASc score were found to be significantly associated with NRP. Binary logistic regression analysis revealed diabetes, LV EF, TIMI thrombus grade, total stented length and CHADSVaSc score to be independent predictors of NRP.ROC analysis revealed a cutoff CHADS-VaSc score of 3 to be a good predictor of NRP (sensitivity 65% and specificity 82%). Conclusion: CHADS-VASc score can be an important pre PCI tool to predict NRP during primary PCI.

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Section: Discussionsupporting

confidence: 50%

The Predictive Value of CHADS-VASC Score in No-Reflow Phenomenon in Primary Percutaneous Coronary Intervention

Farahe

Samore²,

Ali³

et al. 2022

PAFMJ

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“…The development of interventional methods for the treatment of acute coronary syndromes is widely implemented through percutaneous coronary intervention (PCI), which is a life-saving procedure and the best method of reperfusion in acute myocardial infarction with ST-segment elevation [19]. Despite this, there is an ongoing debate among scientists regarding the risks of developing fatal and non-fatal complications after stenting [20,21].…”

Section: Introductionmentioning

confidence: 99%

Dynamics of the Levels of Asymmetric Dimethylarginine and Plasminogen Activator Inhibitor Type 1 in Patients With Acute St-Segment Elevation Myocardial Infarction and Type 2 Diabetes Mellitus Depending on the Reperfusion Strategy

Minukhina,

Kravchun,

Minukhin

et al. 2024

Clin. and prev. med.

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Introduction. Despite the major successes achieved in the treatment of acute coronary syndromes (ACS), acute myocardial infarction (AMI) remains the main cause of death among the working-age population of Ukraine. The means of treatment of interventional cardiology can actually reduce the mortality of patients with ACS, improve the course of the acute period of the disease and ensure less reduction in the functional capabilities of the heart in the future. Among the many pathogenetic mechanisms of vascular inflammation in coronary heart disease and type 2 diabetes, endothelial dysfunction is the determining factor. The aim of the study. To evaluate the levels of plasminogen activator inhibitor type 1, asymmetric dimethylarginine and endothelial nitric oxide synthase on the 10-14th day in patients depending on the presence or absence of concomitant diabetes type 2 and the type of reperfusion therapy. Materials and methods. 130 patients with acute myocardial infarction were examined, who were divided into 2 groups: 1 group consisted of patients with acute myocardial infarction with accompanying type 2 diabetes (n=73), 2 group – patients with acute myocardial infarction without type 2 diabetes (n =57). The quantitative content of the plasminogen activator inhibitor type 1 (PAI-1) was determined by the immunoenzymatic method using a commercial test system manufactured by Technoclone PAI-1 ELISA Kit (Austria), endothelial nitric oxide synthase (NOS) – Enzyme-Linked Immunosorbent Assay (ELISA) Kit For Nitric Oxide Synthase Endothelial, asymmetric dimethylarginine (ADMA) – Immunodiagnostik ADMA ELISA Kit (Austria). Results. Percutaneous coronary intervention (PCI) contributes to a more significant decrease in the content of the marker of endothelial dysfunction – ADMA and an increase in NOS on the 10-14th day of acute myocardial infarction in comparison with standard therapy. During PCI, the level of PAI-1 did not reliably change during treatment due to post-inflammatory and post-traumatic activation of platelets in the vascular wall. Conclusions. In patients with acute myocardial infarction with type 2 diabetes mellitus, percutaneous coronary intervention contributes to a significant decrease in the content of asymmetric dimethylarginine and an increase in NOS on the 10-14th day of acute myocardial infarction, but was not accompanied by a significant decrease in the level of PAI-1, which in general indicates positive effect of performed myocardial revascularization.

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Pathophysiology, Diagnosis, and Management of the No-Reflow Phenomenon

Allencherril

Jneid

Atar

et al. 2019

Cardiovasc Drugs Ther

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Microvascular obstruction in ST elevation myocardial infarction patients undergoing primary percutaneous coronary intervention: another frontier to conquer?

Cited by 5 publications

References 30 publications

The Predictive Value of CHADS-VASC Score in No-Reflow Phenomenon in Primary Percutaneous Coronary Intervention

The Predictive Value of CHADS-VASC Score in No-Reflow Phenomenon in Primary Percutaneous Coronary Intervention

Dynamics of the Levels of Asymmetric Dimethylarginine and Plasminogen Activator Inhibitor Type 1 in Patients With Acute St-Segment Elevation Myocardial Infarction and Type 2 Diabetes Mellitus Depending on the Reperfusion Strategy

Pathophysiology, Diagnosis, and Management of the No-Reflow Phenomenon

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