| Concordant improvements in coronary flow reserve and ST-segment resolution during percutaneous coronary intervention for acute myocardial infarction: a benefit of postconditioning. | |
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MedLine Citation:
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PMID: 18546233 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To assess the effect of ischemic postconditioning on indices of coronary microvascular function during percutaneous coronary intervention (PCI) for acute ST segment elevation myocardial infarction (STEMI). BACKGROUND: Myocardial tissue level perfusion remains suboptimal in many patients with STEMI despite restoration of antegrade flow in the epicardial coronary artery. METHODS: Twenty-four patients with an evolving anterior STEMI were randomized to undergo a previously-validated ischemic postconditioning protocol or usual care during PCI. The extent of resolution of ST segment elevation along with Doppler-tip catheter velocimetry was used as indices of myocardial reperfusion and microvascular function, respectively. RESULTS: Postconditioned patients exhibited a greater, and therefore more rapid, extent of ST segment resolution (postconditioning, 70% +/- 15%; control, 48% +/- 16%; P = 0.0002) by the end of the procedure. Postconditioned patients also exhibited a greater hyperemic coronary vasodilator response at the completion of the procedure (coronary flow velocity reserve, CFVR: postconditioning, 2.2 +/- 0.1; control, 1.5 +/- 0.1; P < 0.0001). The end-procedure CFVR was directly related to the extent of the ST segment resolution (r = 0.85) but inversely related to the absolute magnitude of ST segment elevation at end procedure (r = -0.76). Peak serum creatine kinase was significantly lower in postconditioned patients (postconditioning, 1,524 +/- 435 IU/l; control, 1,862 +/- 561 IU/l; P = 0.03). CONCLUSIONS: Ischemic postconditioning, as described, can be expeditiously performed during PCI for STEMI. Concordant changes in coronary flow reserve and ST segment resolution, measures of microcirculatory function, and myocardial perfusion, were greater in postconditioned patients. |
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Authors:
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Warren K Laskey; Sam Yoon; Norberto Calzada; Mark J Ricciardi |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions Volume: 72 ISSN: 1522-726X ISO Abbreviation: Catheter Cardiovasc Interv Publication Date: 2008 Aug |
Date Detail:
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Created Date: 2008-07-30 Completed Date: 2008-09-25 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100884139 Medline TA: Catheter Cardiovasc Interv Country: United States |
Other Details:
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Languages: eng Pagination: 212-20 Citation Subset: IM |
Copyright Information:
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(c) 2008 Wiley-Liss, Inc. |
Affiliation:
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Division of Cardiology, Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico 87131, USA. wlaskey@salud.unm.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angioplasty, Transluminal, Percutaneous Coronary* Balloon Dilatation* Blood Flow Velocity Blood Pressure Coronary Circulation* Coronary Vessels Electrocardiography* Female Heart Rate Humans Male Middle Aged Myocardial Infarction / physiopathology, therapy* Myocardial Reperfusion Nitroglycerin / administration & dosage Stents Vasodilator Agents / administration & dosage |
| Chemical | |
Reg. No./Substance:
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0/Vasodilator Agents; 55-63-0/Nitroglycerin |
| Comments/Corrections | |
Comment In:
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Catheter Cardiovasc Interv. 2008 Aug 1;72(2):221
[PMID:
18655153
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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