Abstract OBJECTIVES: The impact of periprocedural (before primary percutaneous coronary angioplasty, PCI) abciximab administration on microvascular obstruction in patients with occluded infarct-related artery (IRA) is unknown. METHODS: We studied 36 consecutive patients with first ST elevation myocardial infarction (STEMI) and occluded IRA treated with successful primary PCI within 12 h from symptom onset, who received intravenous abciximab immediately before PCI and 49 matched patients who did not receive abciximab as controls. All patients underwent delayed-enhanced magnetic resonance (DE-MR) 6 +/- 2 days after PCI. Necrosis was judged as transmural when DE was extended to > or =75% of left ventricular (LV) segment thickness. Severe microvascular obstruction was identified as areas of late hypoenhancement surrounded by DE. RESULTS: Time to treatment was comparable in the two groups (182 +/- 60 vs. 188 +/- 110 min, respectively). Transmurality and severe microvascular obstruction were present in 3.03 +/- 2.8 versus 3.09 +/- 2.9 (p = 0.9) and 1.05 +/- 1.5 versus 1.06 +/- 1.8 (p = 0.6) of LV segments, respectively, in the abciximab group versus controls. At multivariate analysis, severe microvascular obstruction was independently associated only with transmural necrosis (OR 1.5, p < 0.001) and age (OR 1.1, p = 0.02) but not with the use of abciximab. CONCLUSIONS: Severe microvascular obstruction after primary PCI of STEMI patients with occluded IRA is related to transmural necrosis but not to the use of abciximab.

Periprocedural abciximab administration in ST elevation myocardial infarction patients - Effect on severe microvascular obstruction beyond the restoration of epicardial coronary flow by primary angioplasty

TARANTINI, GIUSEPPE;ILICETO, SABINO;PERAZZOLO MARRA, MARTINA;CACCIAVILLANI, LUISA;NAPODANO, MASSIMO;RAZZOLINI, RENATO;
2008

Abstract

Abstract OBJECTIVES: The impact of periprocedural (before primary percutaneous coronary angioplasty, PCI) abciximab administration on microvascular obstruction in patients with occluded infarct-related artery (IRA) is unknown. METHODS: We studied 36 consecutive patients with first ST elevation myocardial infarction (STEMI) and occluded IRA treated with successful primary PCI within 12 h from symptom onset, who received intravenous abciximab immediately before PCI and 49 matched patients who did not receive abciximab as controls. All patients underwent delayed-enhanced magnetic resonance (DE-MR) 6 +/- 2 days after PCI. Necrosis was judged as transmural when DE was extended to > or =75% of left ventricular (LV) segment thickness. Severe microvascular obstruction was identified as areas of late hypoenhancement surrounded by DE. RESULTS: Time to treatment was comparable in the two groups (182 +/- 60 vs. 188 +/- 110 min, respectively). Transmurality and severe microvascular obstruction were present in 3.03 +/- 2.8 versus 3.09 +/- 2.9 (p = 0.9) and 1.05 +/- 1.5 versus 1.06 +/- 1.8 (p = 0.6) of LV segments, respectively, in the abciximab group versus controls. At multivariate analysis, severe microvascular obstruction was independently associated only with transmural necrosis (OR 1.5, p < 0.001) and age (OR 1.1, p = 0.02) but not with the use of abciximab. CONCLUSIONS: Severe microvascular obstruction after primary PCI of STEMI patients with occluded IRA is related to transmural necrosis but not to the use of abciximab.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11577/2436338
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