Document Detail


Total occlusion of the infarct-related coronary artery correlates with brachial artery flow-mediated dilation in patients with ST-elevation myocardial infarction.
MedLine Citation:
PMID:  19199114     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Occlusion of the coronary artery is the main cause of ST-elevation myocardial infarction (STEMI). In some patients, it is followed by early spontaneous thrombolysis. In this study, we tried to determine whether spontaneous thrombolysis in the infarct-related artery (IRA) correlates with the state of the endothelium, which we assessed using the brachial artery flow-mediated dilation (FMD) test. METHODS: 52 patients with STEMI were included in the study. Based on the results of coronary angiography performed during the first three days of STEMI, the patients were divided into two groups: Group I (n=33), consisting of patients with remaining total occlusion of the IRA, and Group II (n=19), consisting of patients with spontaneous thrombolysis. We assessed the endothelial function, using the brachial artery FMD test. RESULTS: In Group I, during the first three days of STEMI, brachial artery FMD results were significantly lower than those in Group II: 5.41+/- (3.23-7.41)% versus 10.81+/-(8.00-14.89)%, respectively; P=0.000036. After 7-14 days, this difference disappeared because of significant elevation of the FMD levels in the first group. Group I was characterized by higher levels of high sensitive C-reactive protein (CRP), cholesterol, and cholesterol-LDL and lower usage of angiotensin-converting enzyme (ACE) inhibitors before STEMI. CONCLUSION: The data presented above reveal that spontaneous coronary thrombolysis in patients with acute STEMI is associated with a preserved endothelium-dependent vasodilator response in the brachial artery. It can depend on the levels of hs-CRP, of fasting glucose, and of ACE-inhibitors from previous treatment.
Authors:
Elena Vasilieva; Irina Urazovskaya; Dmitriy Skrypnik; Alexander Shpektor
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acute cardiac care     Volume:  11     ISSN:  1748-295X     ISO Abbreviation:  Acute Card Care     Publication Date:  2009  
Date Detail:
Created Date:  2010-06-14     Completed Date:  2010-09-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101276603     Medline TA:  Acute Card Care     Country:  England    
Other Details:
Languages:  eng     Pagination:  155-9     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Moscow State University of Medicine and Dentistry, Moscow, Russia. helena_vasilieva@mail.ru
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MeSH Terms
Descriptor/Qualifier:
Angiotensin-Converting Enzyme Inhibitors / therapeutic use
Brachial Artery / physiopathology*
Coronary Circulation* / drug effects
Coronary Occlusion / drug therapy,  physiopathology*
Electrocardiogram Pattern
Endothelium, Vascular / drug effects,  physiopathology*
Female
Fibrinolysis
Humans
Male
Middle Aged
Myocardial Infarction / physiopathology*
Prognosis
Vasodilation*
Chemical
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors

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