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Updated: Aug 18, 2026
Myocardial Infarction and Functional Outcome Assessment in Pigs
Published on: April 25, 2014
Late reopening of an occluded infarct related artery improves left ventricular function and long term clinical
F Piscione1, G Galasso, G De Luca
1Department of Cardiology, Federico II University, Naples, Italy. piscione@unina.it <piscione@unina.it>
Insights
Late percutaneous transluminal coronary angioplasty (PTCA) of blocked arteries after myocardial infarction improves heart function. This intervention also reduces cardiac death and major adverse cardiac events, enhancing long-term patient outcomes.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Surgery
Background:
- Chronic total occlusions of infarct-related arteries after myocardial infarction (MI) are common.
- The impact of late percutaneous transluminal coronary angioplasty (PTCA) on left ventricular (LV) function and long-term outcomes remains an area of investigation.
Purpose of the Study:
- To assess the effects of late PTCA on LV function.
- To evaluate the long-term clinical outcomes following PTCA of a chronically occluded infarct-related artery.
Main Methods:
- A cohort of 65 patients with prior MI underwent late PTCA (mean 6 months post-MI).
- Patients were categorized into two groups based on post-PTCA TIMI (thrombolysis in myocardial infarction) flow: Grade 3 (n=35) and Grade 0-2 (n=30).
- Echocardiography and a 3-year follow-up for major adverse cardiac events (MACE) were conducted.
Main Results:
- Patients with TIMI Grade 3 flow post-PTCA showed improved LV ejection fraction and reduced LV volumes at 6-month follow-up compared to those with lower flow.
- Kaplan-Meier analysis revealed a significantly higher incidence of cardiac death and MACE in the lower flow group (TIMI Grade 0-2).
- TIMI 3 flow post-PTCA was identified as an independent predictor of event-free survival.
Conclusions:
- Late PTCA of chronically occluded infarct-related arteries significantly improves LV function.
- The procedure is associated with a reduction in cardiac death and major adverse cardiac events.
- Successful late PTCA of occluded infarct arteries leads to improved long-term clinical outcomes.
Objective:
To assess effects on left ventricular (LV) function and on long term clinical outcome of late percutaneous transluminal coronary angioplasty (PTCA) of a chronically occluded infarct related artery.
Methods:
65 patients who underwent PTCA a mean (SD) of 6.0 (1.2) months after a previous myocardial infarction were divided in two groups according to dilated artery patency status after PTCA: group 1 (35 patients with TIMI (thrombolysis in myocardial infarction) grade 3 flow) and group 2 (30 patients with TIMI grade 0-2 flow). Echocardiography was performed at admission and at six months' follow up. A three year follow up was conducted with major adverse cardiac events (MACE) as end points.
Results:
At follow up, group 1 had improved global LV ejection fraction (48.7% v 43.6%, p < 0.001) and LV indexed end diastolic and end systolic volumes (75 v 86 ml/m(2) and 40 v 53 ml/m(2), respectively, p = 0.011) compared with group 2. Kaplan-Meier analysis showed a higher incidence of cardiac death (p = 0.02) and MACE (p < 0.0001) in group 2. TIMI 3 after PTCA was an independent predictor of event-free survival at follow up.
Conclusion:
Late PTCA of a chronically occluded infarct related artery improves LV function, reduces cardiac death, and improves long term clinical outcome.
