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A Novel Reperfusion Strategy for Primary Percutaneous Coronary Intervention in Patients with Acute ST-Segment

Ji-Fang He1, Yi-Xing Yang1, Jiang-Yuan Li1

  • 1Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, No. 8, Gongti South Road, Chaoyang District, Beijing 100020, China .

Journal of Clinical Medicine
|January 21, 2023
PubMed

Insights

Volume-controlled reperfusion (VCR) shows promising safety and feasibility for ST-segment elevation myocardial infarction (STEMI) patients undergoing percutaneous coronary intervention (PCI). This pilot study indicates VCR is a viable reperfusion strategy, warranting further investigation.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Ischemia Reperfusion Injury

Background:

  • Ischemia reperfusion injury (IRI) is a significant complication in ST-segment elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PCI).
  • A novel reperfusion strategy, volume-controlled reperfusion (VCR), has been developed to address IRI.
  • The study aimed to evaluate the safety and feasibility of VCR in STEMI patients.

Purpose of the Study:

  • To assess the safety and feasibility of volume-controlled reperfusion (VCR) in patients with ST-segment elevation myocardial infarction (STEMI).

Main Methods:

  • Prospective enrollment of consecutive STEMI patients at Beijing Chaoyang Hospital.
  • Feasibility endpoint: procedural success.
  • Safety endpoints: all-cause death, major vascular complications, and major adverse cardiac events (MACE) including cardiac death, myocardial reinfarction, target vessel revascularization (TVR), and heart failure.

Main Results:

  • Procedural success was achieved in 93.3% of 30 enrolled patients.
  • No in-hospital deaths, major vascular complications, or MACE were observed.
  • During a median 16-month follow-up, no deaths or major vascular complications occurred; one patient (3.3%) required TVR post-discharge.

Conclusions:

  • Volume-controlled reperfusion (VCR) demonstrates favorable feasibility and safety in STEMI patients.
  • The pilot study suggests VCR is a promising reperfusion strategy.
  • Larger randomized trials are necessary to confirm VCR's effectiveness in STEMI treatment.
Abstract

Keywords:
ST-segment elevation myocardial infarctionischemia–reperfusion injurymicrovascular obstructionpercutaneous coronary intervention

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