engleski

Impact of intracoronary contrast injection pressure on reperfusion during primary percutaneous coronary intervention in acute ST- segment elevation myocardial infarction: A prospective randomized pilot study

Background: Distal embolization of plaque and thrombotic debris in the infarct-related artery (IRA) may lead to microvascular obstruction resulting in impaired myocardial reperfusion. The aim of the study was to assess the impact of contrast injection pressure in IRA, during primary percutaneous coronary intervention (PCI), on myocardial reperfusion in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods: This prospective, randomized, open label, pilot trial evaluated acute STEMI patients who underwent primary PCI, with blinded evaluation of end points. Patients were assigned to higher injection pressure group A (550 pound/inch2) or lower injection pressure group B (200 pound/inch2). Primary endpoint was the postprocedural incidence of restored myocardial perfusion defined as myocardial blush grade (MBG) 3. Results: Study included 100 consecutive acute STEMI patients, with median age of 63 (56–72) years (77% men) who were randomized to higher and lower injection pressure group. Baseline demographic, clinical and angio- graphic characteristics did not differ significantly between the groups. There were no significant differences be- tween the study groups regarding difference in achieved MBG 3 (33 vs 36 patients, p = 0.247) nor regarding the ST-segment deviation score neither immediately after (3 vs 4 mm, p N 0.3) nor 24 h after primary PCI (2 vs 3 mm, p N 0.3). Conclusion: There was no impact of lower intracoronary contrast injection pressure in comparison to higher in- jection pressure, during primary PCI in patients with acute STEMI, on myocardial reperfusion as assessed by MBG or ST segment changes in the ECG.

STEM, I Primary PCI, No-reflow phenomenon, Intracoronary pressure, Reperfusion, Myocardial blush grade

nije evidentirano