Abstract | BACKGROUND: METHODS AND RESULTS: Thirty-five patients admitted with ST-elevation acute myocardial infarction undergoing primary percutaneous coronary intervention were enrolled in the study. Coronary flow reserve (CFR), index of microvascular resistance (IMR), and IS were assessed 2 days after primary percutaneous coronary intervention and at the 5-month follow-up. The predictors of the 5-month IS were the baseline values of IS (beta=0.6, P<0.001), IMR (beta=0.280, P=0.013), and CFR (beta=-0.276, P=0.017). There were significant correlations between relative change in IS and relative change in measures of microvascular function (IS and CFR [r=-0.51, P=0.002]); IS and IMR ([r=0.55, P=0.001]). In multivariate model, relative changes in IMR (beta=0.552, P=0.001) and CFR (beta=-0.511, P=0.002) were the only predictors of relative change in IS. In patients with an improvement in IMR >33%, the mean IS decreased from 32.3+/-16.9% to 19.3+/-14% (P=0.001) in the follow-up. Similarly, in patients with an improvement in CFR >41%, the mean IS significantly decreased from 29.9+/-20% to 15.8+/-12.4% (P=0.003). But in patients with an improvement in IMR and CFR, which were below than the mean values, IS did not significantly decrease during the follow-up. CONCLUSIONS: Improvement in microvascular function in the infarcted territory is associated with reduction in IS after reperfused ST-elevation acute myocardial infarction. This link suggests that further investigations are warranted to determine whether therapeutic protection of microvascular integrity results in augmentation of infarct healing.
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Authors | Murat Sezer, Emre K Aslanger, Arif O Cimen, Ebru Yormaz, Cuneyt Turkmen, Berrin Umman, Yilmaz Nisanci, Zehra Bugra, Kamil Adalet, Sabahattin Umman |
Journal | Circulation. Cardiovascular interventions
(Circ Cardiovasc Interv)
Vol. 3
Issue 3
Pg. 208-15
(Jun 01 2010)
ISSN: 1941-7632 [Electronic] United States |
PMID | 20484102
(Publication Type: Journal Article)
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Topics |
- Aged
- Atherectomy
- Coronary Angiography
- Electrocardiography
- Female
- Follow-Up Studies
- Hemodynamics
- Humans
- Male
- Microcirculation
- Middle Aged
- Myocardial Infarction
(pathology, physiopathology, therapy)
- Myocardium
(pathology)
- Treatment Outcome
- Ventricular Remodeling
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