![]() Other medications used after PCI were given in accordance with current STEMI guidelines and included clopidogrel (75 mg/d) and aspirin (100 mg/d) indefinitely. PCI was carried out in all patients using a standard method. Use of a platelet glycoprotein IIb/IIIa inhibitor before PCI was at the discretion of the interventional cardiologist if administered, the heparin dose was reduced to 70 IU/kg. A bolus of unfractionated heparin (100 IU/kg) was given intravenously before the procedure. Medication and PCIĪll patients received an oral loading dose of clopidogrel (600 mg) and aspirin (300 mg) immediately after confirmation of STEMI. The ethics committee of Beijing Chao-Yang Hospital approved the study protocol, and written informed consent was obtained from each patient. The study complied with the Declaration of Helsinki. The diagnosis was made and medication, angiography and PCI performed by experienced cardiologists. The exclusion criteria were: primary PCI of the left main coronary artery, left bundle branch block, accelerated idioventricular rhythm, ventricular fibrillation or paced rhythm before the procedure (these patients were excluded due to the distinctive ECG pattern observed in such cases) hemodynamic instability before the procedure previous AMI previous coronary artery bypass graft (CABG) and refusal to participate in the study. Furthermore, we investigated whether pre-angiography STR was related to enzymatic infarct size or clinical prognosis.įrom January 2015 to July 2017, we prospectively recruited 366 patients with STEMI using the following inclusion criteria: chest pain lasting > 30 min ST-segment elevation on the electrocardiogram (ECG) in ≥2 adjacent leads (≥0.2 mV in leads V1–3 and ≥ 0.1 mV in all other leads) the maximal levels of the enzymes, creatine kinase-muscle/brain (CK-MB) and cardiac troponin I (cTnI) were elevated to three times the upper limit of normal and referral for primary PCI was made within the first 6–12 h after symptom onset. In this study, we evaluated whether pre-angiography STR reliably predicted spontaneous reperfusion of the IRA in patients with AMI undergoing primary PCI. Īlthough pre-procedural TIMI flow is recognized to be a reliable predictor of cardiac mortality in patients with STEMI, the prognostic value of STR preceding primary PCI is still not well established. It was demonstrated that STR after PCI was a strong and independent predictor of cardiac mortality and recurrence of myocardial infarction (MI) across all spectra of clinical risk, and a lack of STR was even of prognostic value 6 years after the occurrence of AMI. A quick estimation of maximal ST resolution (STR) as a surrogate marker of blood flow provides similar results to analysis of the sum of STR in all leads. ST-segment changes may be evaluated either as the sum of ST-segment deviations in all leads in a given infarction area or in the single lead with the largest ST deviation. The most common non-invasive method for evaluating reperfusion is to analyze the resolution of ischemic ST-segment changes in a series of ECG records. In an analysis of randomized trials, pre-procedural TIMI-3 flow was a more powerful prognostic predictor than TIMI-3 flow after angioplasty, underscoring the importance of early flow restoration in patients with STEMI. Post-procedural TIMI flow of the IRA is used for risk stratification of patients with STEMI, but pre-procedural TIMI flow may also be an important predictor of clinical prognosis. Thrombolysis in myocardial infarction (TIMI) flow grade estimates epicardial flow by evaluating the flow of contrast material in epicardial coronary arteries during angiography. Reperfusion of the infarct-related artery (IRA) is a critical predictor of prognosis in patients with acute myocardial infarction (AMI) and may be evaluated either angiographically or non-invasively. ConclusionsĪssessment of STR could potentially be used to stratify risk in patients with STEMI before PCI. STR was classified as total (≥70% group I), partial (≥30 and 70% may predict a better clinical outcome. Standard 12-lead ECG tracings were recorded at first medical contact, immediately prior to arterial puncture and 60 min after PCI. Patients with STEMI undergoing primary PCI were recruited. We investigated whether pre-angiography STR predicted spontaneous IRA reperfusion in STEMI patients. ST resolution (STR) after AMI is a non-invasive indicator of IRA reperfusion. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |