Percutaneous Intervention in ST-Elevation Myocardial Infarction: Culprit-only or Complete Revascularization?

Osório, Ana Paula Susin; Quadros, Alexandre Schaan de; Vieira, José Luiz da Costa; Portal, Vera Lúcia

doi:10.5935/abc.20170174

Cited by 3 publications

(3 citation statements)

References 29 publications

(34 reference statements)

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“…Primary percutaneous intervention (PCI) is the major therapy for acute ST segment elevation myocardial infarction (STEMI) in the age of revascularization. This conclusion is supported by decreased rates of recurrent ischemia or infarction and high success rates in restoring antegrade blood flow in the infracted artery (IRA) [1] .…”

Section: Introductionmentioning

confidence: 94%

Predictors of Suboptimal Reperfusion and Short Term Mortality in Patients Presented With Acute ST-Segment Elevation Myocardial Infarction and Treated With Primary Percutaneous Coronary Intervention

Abdelmoneum¹,

Arafa²,

Mohamed³

et al. 2023

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Background: Predictors of Suboptimal reperfusion are still unclear. Aim: This study aimed to determine the factors that may indicate suboptimal reperfusion and short-term mortality in patients who were diagnosed with acute ST-segment elevation myocardial infarction (STEMI) and underwent primary percutaneous coronary intervention (pPCI). Patients and methods: This multicenter prospective comparative study, conducted at Benha University hospitals and National Heart Institute, included 400 patients (age<18 years and both sex) with acute STEMI, who were treated with PPCI. They were divided equally into 2 groups; suboptimal and optimal reperfusion groups (TIMI < III Vs.TIMI III respectively). Clinical data was collected. ECG, laboratory investigations, echocardiographic study, PPCI and 6 months follow up were done to all patients included. Results: This study showed that advanced age (60.4±8.2), family history of CAD, dyslipidemia, being diabetic, prolonged Pain to PCI time, higher random blood sugar (RBG) at the time of presentation, Killip class >1, heavy thrombus burden, prediltation, multiple stents insertion and longer stent length are predictors of the SOR after PPCI. While, Patients on long term beta blockers (BB) and angiotensin-converting enzyme inhibitor (ACEI) are less likely to develop SOR. Furthermore, patients with SOR are more likely to develop in-hospital arrhythmias, heart failure, acute mitral regurge and inhospital mortality. Additionally, it increases 6-months risk of reischemia and mortality. Conclusions: Predicting the occurrence of no-reflow following pPCI can be achieved by considering various factors, such as clinical data, laboratory results, angiographic features, and procedural characteristics. Heavy thrombus burden, prediltation, dyslipidemia, longer stent length, pain to PCI time and RBG >300 (mg/dL) at the time of presentation were found to be the most predictable variables to SOR. Long term use of BB and ACEI were found to be significant independent factors that decreased the likelihood of TIMI9h were considered the most predictable variables to mortality in no reflow.

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Section: Introductionmentioning

confidence: 94%

Predictors of Suboptimal Reperfusion and Short Term Mortality in Patients Presented With Acute ST-Segment Elevation Myocardial Infarction and Treated With Primary Percutaneous Coronary Intervention

Abdelmoneum¹,

Arafa²,

Mohamed³

et al. 2023

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“…A deflated balloon catheter is advanced into an obstructed artery via the saphenous or radial artery. Inflation of the balloon reverses the narrowing of the blood vessel ( Osorio et al, 2017 ). Alternatively, stents are placed in the narrowed artery to ensure blood vessels remain dilated.…”

Section: Treatment Status Of Ischemic Heart Diseasementioning

confidence: 99%

Therapeutic Angiogenesis of Chinese Herbal Medicines in Ischemic Heart Disease: A Review

et al. 2018

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Ischemic heart disease (IHD) is one of the primary causes of death around the world. Therapeutic angiogenesis is a promising innovative approach for treating IHD, improving cardiac function by promoting blood perfusion to the ischemic myocardium. This treatment is especially important for targeting patients that are unable to undergo angioplasty or bypass surgery. Chinese herbal medicines have been used for more than 2,500 years and they play an important role alongside contemporary medicines in China. Growing evidence in animal models show Chinese herbal medicines can provide therapeutic effect on IHD by targeting angiogenesis. Identifying the mechanism in which Chinese herbal medicines can promote angiogenesis in IHD is a major topic in the field of traditional Chinese medicine, and has the potential for advancing therapeutic treatment. This review summarizes the progression of research and highlights potential pro-angiogenic mechanisms of Chinese herbal medicines in IHD. In addition, an outline of the limitations of Chinese herbal medicines and challenges they face will be presented.

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“…1 With acute ST-Elevation Myocardial Infarction (STEMI), percutaneous coronary intervention (PPCI) is currently considered the treatment of choice. 2 While its benefits remain undeniable, its appropriate use remains a contentious issue. The occurrence of cardiogenic shock (CS) is about 5-10% among acute myocardial infarctions (AMIs), a situation related to high in-hospital mortality.…”

Section: Introductionmentioning

confidence: 99%

In-Hospital Mortality Among Patients with Acute Coronary Syndrome and Cardiogenic Shock Treated with Percutaneous Coronary Intervention and Intra-Aortic Balloon Pump

Butt¹,

Iqbal²,

Dasti³

et al. 2023

PJMHS

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Objective: The object of our research was to determine whether intra-aortic balloon pump-assisted PCI improved overall clinical outcomes during hospitalization, as well as to predict in-hospital mortality and cardiogenic shock. Methods: This retrospective study was carried out at National Institute of Cardiovascular Diseases Karachi. We enrolled 60 consecutive patients with a history of AMI complicated by cardiogenic shock. These patients underwent PCI with insertion of an IABP between 1st September 2019 and 28th February 2020. Patients with cardiogenic shock would have better survival if the IABP was inserted before PCI rather than after PCI was performed. The prospective study included 60 patients (33 patients received IABP before PCI, before and 27 after PCI) suffering from cardiogenic shock complicating acute myocardial infarction who underwent PCI with IABP. SPSS version 23.0 was used to analyze all the data. Results: Based on the type of treatment, we divided individuals into two groups in our study. The IABPs were inserted before PCI in 33 patients in group A, and the pumps were started after PCI in 27 participants in group B. It was significantly different regarding the 30-day mortality rate between IABP support after PCI and IABP-assisted PCI (59.2% versus 18.1%, respectively, p = 0.006). Among the entire study population, no reinfections or repeat PCI were reported. There was no significant difference between these two groups in the rates of emergency bypass surgery and cerebral vascular events. Practical Implication: This research study on in-hospital mortality among patients with acute coronary syndrome and cardiogenic shock treated with PCI and IABP has practical implications that benefit the community. It enhances patient outcomes, informs clinical decision-making, contributes to treatment guidelines and protocols, facilitates healthcare resource allocation, and inspires future research and innovation. Ultimately, the study aims to improve the quality of care provided to patients in this specific population, leading to reduced mortality rates and improved patient well-being Conclusion: This study concluded that PCI assisted by IABP results in a better outcome for patients with cardiogenic shock complicating acute myocardial infarction and a lower mortality rate compared to IABP after PCI. Keywords: In-hospital mortality, percutaneous coronary intervention, intra-aortic balloon pump.

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Percutaneous Intervention in ST-Elevation Myocardial Infarction: Culprit-only or Complete Revascularization?

Cited by 3 publications

References 29 publications

Predictors of Suboptimal Reperfusion and Short Term Mortality in Patients Presented With Acute ST-Segment Elevation Myocardial Infarction and Treated With Primary Percutaneous Coronary Intervention

Predictors of Suboptimal Reperfusion and Short Term Mortality in Patients Presented With Acute ST-Segment Elevation Myocardial Infarction and Treated With Primary Percutaneous Coronary Intervention

Therapeutic Angiogenesis of Chinese Herbal Medicines in Ischemic Heart Disease: A Review

In-Hospital Mortality Among Patients with Acute Coronary Syndrome and Cardiogenic Shock Treated with Percutaneous Coronary Intervention and Intra-Aortic Balloon Pump

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