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Myocardial Infarction and Functional Outcome Assessment in Pigs
Published on: April 25, 2014
Clinical and angiographic follow-up after coronary recanalization during acute myocardial infarction
G Steffenino1, B Meier, L Finci
1Cardiology Centre, University Hospital, Geneva, Switzerland.
Insights
Percutaneous transluminal coronary angioplasty (PTCA) successfully recanalized blocked arteries in 82% of acute myocardial infarction patients. Early intervention and collaterals improved left ventricular function, with 86% remaining asymptomatic long-term.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiovascular Medicine
Background:
- Acute myocardial infarction (AMI) requires timely reperfusion to preserve left ventricular function.
- Percutaneous transluminal coronary angioplasty (PTCA) and thrombolysis are key interventions for AMI.
- Evaluating the efficacy and safety of these procedures is crucial.
Purpose of the Study:
- To assess the success rate and long-term outcomes of PTCA with or without intracoronary streptokinase in evolving myocardial infarction.
- To evaluate the impact of early recanalization and collateral circulation on left ventricular function.
Main Methods:
- Coronary angiography and PTCA/thrombolysis were performed in 50 AMI patients within 288 minutes of symptom onset.
- Recanalization success rates and procedural complications were recorded.
- Follow-up angiography and clinical assessments evaluated long-term results and left ventricular function.
Main Results:
- Recanalization was achieved in 37 patients (82% success rate) with no procedure-related deaths.
- Late angiography showed restenosis or reocclusion in 23% of patients.
- Left ventricular ejection fraction improved significantly in patients with early recanalization (<180 min) and collaterals.
Conclusions:
- Coronary angioplasty offers good long-term results with acceptable risk in evolving myocardial infarction.
- Early recanalization and the presence of collaterals are associated with better preservation of left ventricular function.
- PTCA is a valuable treatment option for acute myocardial infarction.
Abstract:
Coronary angiography followed by percutaneous transluminal coronary angioplasty and/or intracoronary streptokinase infusion was performed in 50 patients 288 +/- 162 min after the onset of symptoms of acute myocardial infarction. Subocclusion of the infarct-related vessel was found in 5 patients, all of whom had angioplasty of the residual stenosis. Recanalization was achieved in 37 patients (success rate 82%). There was no procedure-related death. One patient died 4 days after the intervention. Control coronary angiography 5 +/- 2 months after the procedure in 35 of 42 patients with recanalization documented recurrence of stenosis or reocclusion in 8 (23%). Comparison of preintervention and control angiograms in 33 patients showed an increase in left ventricular ejection fraction from 55 +/- 8 to 61 +/- 13%, p less than 0.001, in patients with collaterals to the infarct-related vessel and/or recanalization within 180 min after the onset of pain, and from 55 +/- 9 to 59 +/- 8%, nonsignificant, in patients with recanalization later than 180 min and without collaterals. At follow-up 7 +/- 4 months after the procedure, 1 patient had died and 36 (86%) were asymptomatic. Good long-term results can be achieved at a reasonable risk by coronary angioplasty with or without thrombolysis in evolving myocardial infarction. Left ventricular function is better preserved in patients with collaterals and/or early recanalization.
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