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Correlation between balloon release pressure and no-reflow in patients with acute myocardial infarction undergoing
Yanfei Wang1, Min Yao2, Haibo Liu2
1Department of Cardiovascular Disease, Affiliated Hospital of Hebei University, Baoding, Hebei 071000, China.
Insights
High balloon release pressure during direct percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) significantly increases no-reflow events. Lowering balloon pressure below 1823.4 kPa is recommended to reduce no-reflow incidence.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Medicine
Background:
- Balloon inflation pressure during direct percutaneous coronary intervention (PCI) may be associated with an increased incidence of no-reflow phenomenon.
- No-reflow is a complication that can negatively impact outcomes after PCI.
Purpose of the Study:
- To analyze the correlation between balloon release pressure and the incidence of no-reflow in patients with acute myocardial infarction (AMI) undergoing direct PCI.
- To evaluate the impact of different balloon inflation pressures on clinical and biochemical markers post-PCI.
Main Methods:
- A randomized controlled study involving 156 AMI patients undergoing direct PCI from January 2010 to December 2012.
- Patients were divided into conventional and high balloon pressure groups.
- Angiography assessed Thrombolysis in Myocardial Infarction (TIMI) grade; biochemical markers and psychological scales (HAMD, SAS) were measured pre- and post-PCI.
Main Results:
- The high-pressure group showed a significantly higher incidence of no-reflow (17.11% vs. 6.25%, P < 0.05) compared to the conventional pressure group.
- Significant differences in CK-MB, HAMD, and SAS were observed post-PCI, particularly elevated CK-MB in the high-pressure group.
- While CK-MB, HAMD, SAS, and β-TG were comparable pre-PCI, they changed significantly post-intervention.
Conclusions:
- Utilizing a balloon release pressure below 1823.4 kPa during stent implantation may be a superior strategy to mitigate no-reflow occurrence after direct PCI.
- Optimizing balloon pressure is crucial for improving procedural success and patient outcomes in AMI treated with direct PCI.
Background:
Balloon release pressure may increase the incidence of no reflow after direct percutaneous coronary intervention (PCI). This randomized controlled study was designed to analyze the correlation between balloon release pressure and no-reflow in patients with acute myocardial infarction (AMI) undergoing direct PCI.
Methods:
There were 156 AMI patients who underwent PCI from January 1, 2010 to December 31, 2012, and were divided into two groups according to the stent inflation pressure: a conventional pressure group and a high pressure group. After PCI, angiography was conducted to assess the thrombolysis in myocardial infarction (TIMI) grade with related artery. Examinations were undertaken on all patients before and after the operation including cardiac enzymes, total cholesterol, low-density lipoprotein, blood glucose, homocysteine , β-thromboglobulin (β-TG), Hamilton depression scale (HAMD) and self-rating anxiety scale (SAS). After interventional therapy, the afore-mentioned parameters in both the conventional pressure group and high pressure group were again analyzed.
Results:
The results showed that CK-MB, HAMD, SAS were significantly different (P < 0.05) in all patients after PCI, especially the CK-MB in the high pressure group ((25.7 ± 7.6) U/L vs. (76.7 ± 11.8) U/L). CK-MB, HAMD, SAS, and β-TG were comparative before PCI but they were significantly changed (P < 0.05) after intervention. No-reflow phenomenon occurred in 13 patients in the high pressure group, which was significantly higher than in the conventional pressure group (17.11% vs. 6.25%, P < 0.05).
Conclusion:
In stent implantation, using a pressure less than 1823.4 kPa balloon to release pressure may be the better choice to reduce the occurrence of no-reflow following direct PCI.
