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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 cor...

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Detalles Bibliográficos
Autores principales: Stambuk, Kresimir, Krcmar, Tomislav, Zeljkovic, Ivan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6709366/
https://www.ncbi.nlm.nih.gov/pubmed/31463362
http://dx.doi.org/10.1016/j.ijcha.2019.100412
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author Stambuk, Kresimir
Krcmar, Tomislav
Zeljkovic, Ivan
author_facet Stambuk, Kresimir
Krcmar, Tomislav
Zeljkovic, Ivan
author_sort Stambuk, Kresimir
collection PubMed
description 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/inch(2)) or lower injection pressure group B (200 pound/inch(2)). 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 angiographic characteristics did not differ significantly between the groups. There were no significant differences between 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 > 0.3) nor 24 h after primary PCI (2 vs 3 mm, p > 0.3). CONCLUSION: There was no impact of lower intracoronary contrast injection pressure in comparison to higher injection pressure, during primary PCI in patients with acute STEMI, on myocardial reperfusion as assessed by MBG or ST segment changes in the ECG. The study was registered at registry ClinicalTrials.gov with the registration number: NCT03445364, on February 26th 2018.
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spelling pubmed-67093662019-08-28 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 Stambuk, Kresimir Krcmar, Tomislav Zeljkovic, Ivan Int J Cardiol Heart Vasc Original Paper 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/inch(2)) or lower injection pressure group B (200 pound/inch(2)). 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 angiographic characteristics did not differ significantly between the groups. There were no significant differences between 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 > 0.3) nor 24 h after primary PCI (2 vs 3 mm, p > 0.3). CONCLUSION: There was no impact of lower intracoronary contrast injection pressure in comparison to higher injection pressure, during primary PCI in patients with acute STEMI, on myocardial reperfusion as assessed by MBG or ST segment changes in the ECG. The study was registered at registry ClinicalTrials.gov with the registration number: NCT03445364, on February 26th 2018. Elsevier 2019-08-20 /pmc/articles/PMC6709366/ /pubmed/31463362 http://dx.doi.org/10.1016/j.ijcha.2019.100412 Text en © 2019 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Paper
Stambuk, Kresimir
Krcmar, Tomislav
Zeljkovic, Ivan
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
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6709366/
https://www.ncbi.nlm.nih.gov/pubmed/31463362
http://dx.doi.org/10.1016/j.ijcha.2019.100412
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