Minimum Salvaged Myocardium After Rescue Percutaneous Coronary Intervention: Quantification by Cardiac Magnetic Resonance

Ruiz-Nodar, Juan M.; Feliu, Eloísa; Sánchez-Quiñones, Jessica; Valencia-Martín, José Lorenzo; García, Milagros; Pineda, Javier; Martín, Patricia; Mainar, Vicente; Bordes, Pascual; Heras, Santiago; Quintanilla, Maria A.; Sogorb, Francisco

doi:10.1016/j.rec.2011.04.013

Cited by 13 publications

(1 citation statement)

References 23 publications

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“…The small number of late-PCI and R-PCI patients make statistical comparisons difficult. Our observations are similar to Ruiz-Nodar who demonstrated only 9% MSI with R-PCI [ 33 ], and the MERLIN study demonstrated similar LV function at 30 days in R-PCI compared with conservatively treated patients [ 34 ]. The current evidence base demonstrates a lack of prognostic benefit with late PCI [ 35 ].…”

Section: Discussionsupporting

confidence: 89%

Prevalence and extent of infarct and microvascular obstruction following different reperfusion therapies in ST-elevation myocardial infarction

Khan

Razvi

Nazir

et al. 2014

Journal of Cardiovascular Magnetic Resonance

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BackgroundMicrovascular obstruction (MVO) describes suboptimal tissue perfusion despite restoration of infarct-related artery flow. There are scarce data on Infarct Size (IS) and MVO in relation to the mode and timing of reperfusion. We sought to characterise the prevalence and extent of microvascular injury and IS using Cardiovascular magnetic resonance (CMR), in relation to the mode of reperfusion following acute ST-Elevation Myocardial Infarction (STEMI).MethodsCMR infarct characteristics were measured in 94 STEMI patients (age 61.0 ± 13.1 years) at 1.5 T. Seventy-three received reperfusion therapy: primary percutaneous coronary-intervention (PPCI, n = 47); thrombolysis (n = 12); rescue PCI (R-PCI, n = 8), late PCI (n = 6). Twenty-one patients presented late (>12 hours) and did not receive reperfusion therapy.ResultsIS was smaller in PPCI (19.8 ± 13.2% of LV mass) and thrombolysis (15.2 ± 10.1%) groups compared to patients in the late PCI (40.0 ± 15.6%) and R-PCI (34.2 ± 18.9%) groups, p <0.001. The prevalence of MVO was similar across all groups and was seen at least as frequently in the non-reperfused group (15/21, [76%] v 33/59, [56%], p = 0.21) and to a similar magnitude (1.3 (0.0-2.8) v 0.4 [0.0-2.9]% LV mass, p = 0.36) compared to patients receiving early reperfusion therapy. In the 73 reperfused patients, time to reperfusion, ischaemia area at risk and TIMI grade post-PCI were the strongest independent predictors of IS and MVO.ConclusionsIn patients with acute STEMI, CMR-measured MVO is not exclusive to reperfusion therapy and is primarily related to ischaemic time. This finding has important implications for clinical trials that use CMR to assess the efficacy of therapies to reduce reperfusion injury in STEMI.

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Section: Discussionsupporting

confidence: 89%