scholarly journals The outcomes in patients with acute non-ST elevation myocardial infarction treated with percutaneous coronary intervention within 24h after onset, delayed percutaneous coronary intervention or optimal medical therapy at initial hospitalization and during one-year follow-up: the experience from the Croatian branch of the ISACS-CT Registry

2018 ◽  
Vol 13 (11-12) ◽  
pp. 311-312
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Medical Therapy ◽  
Coronary Intervention ◽  
St Elevation Myocardial Infarction ◽  
Percutaneous Coronary ◽  
St Elevation ◽  
Initial Hospitalization ◽  
One Year

scholarly journals Compared Outcomes of ST-Elevation Myocardial Infarction Patients with Multivessel Disease Treated with Primary Percutaneous Coronary Intervention and Preserved Fractional Flow Reserve of Non-Culprit Lesions Treated Conservatively and of Those with Low Fractional Flow Reserve Managed Invasively: Insights from the FLOWER MI trial.

2021 ◽  
Author(s):  
Pierre Denormandie ◽  
Tabassome Simon ◽  
Guillaume Cayla ◽  
Philippe Gabriel Steg ◽  
Gilles Montalescot ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Primary Outcome ◽  
Coronary Intervention ◽  
St Elevation Myocardial Infarction ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Percutaneous Coronary ◽  
St Elevation ◽  
One Year

Background: In patients with ST-elevation myocardial infarction (STEMI) and multivessel disease, percutaneous coronary intervention (PCI) for non-culprit lesions guided by FFR is superior to treatment of the culprit lesion alone. Whether deferring non-culprit PCI is safe in this specific context is questionable. We aimed to assess clinical outcomes at one-year in STEMI patients with multivessel coronary artery disease and an FFR-guided strategy for non-culprit lesions, according to whether or not ≥1 PCI was performed. Methods: Outcomes were analyzed in patients of the randomized FLOWER MI (Flow Evaluation to Guide Revascularization in Multivessel ST-Elevation Myocardial Infarction) trial in whom, after successful primary PCI, non-culprit lesions were assessed using FFR. The primary outcome was a composite of all-cause death, non-fatal MI, and unplanned hospitalization with urgent revascularization at one year. Results: Among 1,171 patients enrolled in this study, 586 were assigned to the FFR-guided group: 388 (66%) of them had ≥1 PCI and 198 (34%) had no PCI. Mean FFR before decision (i.e., PCI or not) of non-culprit lesions were 0.75±0.10 and 0.88±0.06, respectively. During follow-up, a primary outcome event occurred in 16 of 388 patients (4.1%) in patients with PCI and in 16 of 198 patients (8.1%) in patients without PCI (adjusted hazard ratio, 0.42; 95% confidence interval, 0.20 to 0.88; P = 0.02). Conclusions: In patients with STEMI undergoing complete revascularization guided by FFR measurement, those with ≥1 PCI had lower event rates at 1 year, compared with patients with deferred PCI, suggesting that deferring lesions judged relevant by visual estimation but with FFR >0.80 may not be optimal in this context. Future randomized studies are needed to confirm this data.

scholarly journals Evaluation of coronary microcirculation by myocardial contrast echocardiography in patients of ST elevation myocardial infarction

2020 ◽  
Vol 8 (10) ◽  
pp. 3534
Author(s):  
Avijit Singh ◽  
Vishwa Deepak Tripathi ◽  
Pushpraj Patel
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Contrast Echocardiography ◽  
Coronary Intervention ◽  
Filling Defect ◽  
St Elevation Myocardial Infarction ◽  
Timi Flow ◽  
Percutaneous Coronary ◽  
St Elevation

Background: No reflow phenomenon observed during catheter intervention has been associated with poor cardiovascular outcomes. Assessment of filling defect by myocardial contrast echocardiography (MCE) correlates with no reflow. Limited studies are available for the same. This study was designed to look for impact of type of therapy for revascularization (whether percutaneous coronary intervention or thrombolysis) and its evaluation by MCE and follow up echocardiography parameters.Methods: Total 50 consecutive patients of ST-elevation myocardial infarction (STEMI) were taken study including recent STEMI (within 7 days). After all routine investigations patient underwent coronary angiography and percutaneous coronary intervention (PCI) procedure. Following completion of procedure, thrombolysis in myocardial infarction (TIMI) flow, TIMI frame count, and myocardial blush grade were calculated and noted. Post revascularization contrast echocardiography was done after patient stabilization. Findings were correlated with cath-lab parameters applying appropriate statistical tests. Follow up was planned after 30 days.Results: 50 consecutive patients admitted with acute myocardial infarction (MI) or recent MI (0-7 day) who underwent primary PCI - 82% (n=41) or thrombolysed with various thrombolytic agents - 18% (n=9). Mean age of the study group was 55.02±12.65 years. There was significant association in between TIMI 3 flow and absence of filling defect in MCE (p=0.03), but no significant association found in between revascularization therapy (Either PCI or Thrombolysis) and filling defect in MCE (p=0.08).Conclusions: Our study found good correlation between myocardial contrast score with angiographically measured TIMI flow and improved echocardiographic findings on follow up.

Sign in / Sign up

Export Citation Format

Share Document