UNLABELLED: Higher angiographic perfusion score (APS) following percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) has been shown to be associated with improved clinical outcomes. The association between APS after STEMI and left ventricular remodeling as assessed by volumetric parameters derived from left ventriculography has not been assessed. METHODS: The APS (the arithmetic sum of the TIMI Flow Grade (TFG) and TIMI Myocardial Perfusion grade (TMPG) before and after percutaneous coronary intervention (PCI), range of 0-12) was assessed in 168 patients from the GRACIA-2 trial. Left ventriculograms performed in the 30 degrees right anterior oblique projection were obtained among 148 patients at initial angiography (prior to PCI) and at 6 weeks. The association of APS with markers of left ventricular remodeling at 6-weeks was examined using left ventricular ejection fraction, delta end systolic volume, delta stroke volume and wall motion index. RESULTS: Full perfusion (APS 10-12), as compared to partial perfusion (APS 4-9) or failed perfusion (APS 0-3), was associated with a greater left ventricular ejection fraction (61.6% +/- 10.0 vs. 56.9% +/- 12.5 vs. 49.8% +/- 16.9, P = 0.015), a decrease in left ventricular end systolic volume indicating favorable remodeling (mean -4.1 cc +/- 17.3 vs. +2.0 cc +/- 17.3 vs. +9.8 cc +/- 16.1, P = 0.015), a greater improvement in left ventricular stroke volume (mean +13.7 cc +/- 17.1 vs. +6.7 cc +/- 15.5 vs. +1.2 cc +/- 13.4, P = 0.009) and a decreased wall motion index (number of chords in the hypokinetic region) (mean 15.1 +/- 16.4 vs. 21.4 +/- 20.5 vs. 32.9 +/- 22.1, P = 0.026) at 6 weeks. CONCLUSION: In conclusion, among patients treated with combined reperfusion and revascularization strategies for STEMI, higher APS is associated with more favorable markers of left ventricular remodeling and improved 6-week left ventricular function.
RCT Entities:
UNLABELLED: Higher angiographic perfusion score (APS) following percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) has been shown to be associated with improved clinical outcomes. The association between APS after STEMI and left ventricular remodeling as assessed by volumetric parameters derived from left ventriculography has not been assessed. METHODS: The APS (the arithmetic sum of the TIMI Flow Grade (TFG) and TIMI Myocardial Perfusion grade (TMPG) before and after percutaneous coronary intervention (PCI), range of 0-12) was assessed in 168 patients from the GRACIA-2 trial. Left ventriculograms performed in the 30 degrees right anterior oblique projection were obtained among 148 patients at initial angiography (prior to PCI) and at 6 weeks. The association of APS with markers of left ventricular remodeling at 6-weeks was examined using left ventricular ejection fraction, delta end systolic volume, delta stroke volume and wall motion index. RESULTS: Full perfusion (APS 10-12), as compared to partial perfusion (APS 4-9) or failed perfusion (APS 0-3), was associated with a greater left ventricular ejection fraction (61.6% +/- 10.0 vs. 56.9% +/- 12.5 vs. 49.8% +/- 16.9, P = 0.015), a decrease in left ventricular end systolic volume indicating favorable remodeling (mean -4.1 cc +/- 17.3 vs. +2.0 cc +/- 17.3 vs. +9.8 cc +/- 16.1, P = 0.015), a greater improvement in left ventricular stroke volume (mean +13.7 cc +/- 17.1 vs. +6.7 cc +/- 15.5 vs. +1.2 cc +/- 13.4, P = 0.009) and a decreased wall motion index (number of chords in the hypokinetic region) (mean 15.1 +/- 16.4 vs. 21.4 +/- 20.5 vs. 32.9 +/- 22.1, P = 0.026) at 6 weeks. CONCLUSION: In conclusion, among patients treated with combined reperfusion and revascularization strategies for STEMI, higher APS is associated with more favorable markers of left ventricular remodeling and improved 6-week left ventricular function.
Authors: Aleksander Araszkiewicz; Maciej Lesiak; Stefan Grajek; Marek Prech; Marek Grygier; Tatiana Mularek-Kubzdela; Andrzej Cieslinski Journal: Int J Cardiol Date: 2006-06-21 Impact factor: 4.164
Authors: Leonarda Galiuto; Francesca A Gabrielli; Antonella Lombardo; Giuseppe La Torre; Antonio Scarà; Antonio G Rebuzzi; Filippo Crea Journal: Heart Date: 2006-09-15 Impact factor: 5.994
Authors: C Michael Gibson; Christopher P Cannon; Sabina A Murphy; Susan J Marble; Hal V Barron; Eugene Braunwald Journal: Circulation Date: 2002-04-23 Impact factor: 29.690
Authors: Elliott M Antman; Daniel T Anbe; Paul Wayne Armstrong; Eric R Bates; Lee A Green; Mary Hand; Judith S Hochman; Harlan M Krumholz; Frederick G Kushner; Gervasio A Lamas; Charles J Mullany; Joseph P Ornato; David L Pearle; Michael A Sloan; Sidney C Smith; Joseph S Alpert; Jeffrey L Anderson; David P Faxon; Valentin Fuster; Raymond J Gibbons; Gabriel Gregoratos; Jonathan L Halperin; Loren F Hiratzka; Sharon Ann Hunt; Alice K Jacobs Journal: Circulation Date: 2004-08-31 Impact factor: 29.690
Authors: Yuri B Pride; Jacqueline L Buros; Erin Lord; Matthew C Southard; Caitlin J Harrigan; Lauren N Ciaglo; Marc S Sabatine; Christopher P Cannon; C Michael Gibson Journal: J Thromb Thrombolysis Date: 2007-07-12 Impact factor: 2.300
Authors: Rainer Hoffmann; Philipp Haager; Jan Arning; Philipp Christott; Peter Radke; Rüdiger Blindt; Jan Ortlepp; Wolfgang Lepper; Peter Hanrath Journal: Am J Cardiol Date: 2003-11-01 Impact factor: 2.778
Authors: K P Balachandran; C Berry; J Norrie; B D Vallance; M Malekianpour; T J Gilbert; A C H Pell; K G Oldroyd Journal: Heart Date: 2004-12 Impact factor: 5.994
Authors: Tomasz Rakowski; Jacek Legutko; Pawel Kleczynski; Agata Brzozowska-Czarnek; Artur Dziewierz; Zbigniew Siudak; Waldemar Mielecki; Andrzej Urbanik; Jacek S Dubiel; Dariusz Dudek Journal: J Thromb Thrombolysis Date: 2010-11 Impact factor: 2.300
Authors: Anne Bethke; Limalanathan Shanmuganathan; Geir Øystein Andersen; Jan Eritsland; David Swanson; Nils Einar Kløw; Pavel Hoffmann Journal: Eur Radiol Date: 2018-07-06 Impact factor: 5.315