OBJECTIVES: We conducted a randomized study to compare the effect of direct stenting (DS) and conventional stenting (CS) on post-procedural index of microcirculatory resistance (IMR) values. BACKGROUND:Direct stenting has been suggested to reduce periprocedural microcirculatory injury compared with stenting that follows pre-dilation (CS). The index of microcirculatory resistance is a sensitive invasive marker of coronary microvascular resistance. METHODS:Fifty patients admitted for elective percutaneous coronary intervention (PCI) were included. All patients had stable angina (Canadian Cardiovascular Society class <IV) related to a lesion suitable for DS and were randomized to DS (n = 25) or CS (n = 25). Baseline demographics and clinical and procedural data were comparable in both groups. An intracoronary pressure/temperature sensor-tipped guide wire was used. Thermodilution curves were obtained at baseline and during maximal hyperemia achieved by infusion of intravenous adenosine. The index of microcirculatory resistance was calculated from the ratio of the mean distal coronary pressure at maximal hyperemia to the inverse of mean hyperemic transit time. RESULTS: After otherwise-uneventful PCI, patients treated with CS had significantly greater IMR (DS 13 +/- 3, CS 24 +/- 14; p < 0.01) and tended to have greater post-PCI troponin T values (DS 0.035 +/- 0.04, CS 0.17 +/- 0.02; p = 0.07). In the whole sample, 20% of patients had post-PCI troponin release (troponin T >0.03 ng/ml). Patients with troponin elevation had significantly greater post-PCI IMR values than patients without troponin elevation: 24.7 +/- 13.2 versus 16.9 +/- 10.2; p = 0.04. CONCLUSIONS: In patients undergoingsuccessful coronary stenting for stable angina, DS is associated with reduced microvascular dysfunction induced by PCI as compared with CS.
RCT Entities:
OBJECTIVES: We conducted a randomized study to compare the effect of direct stenting (DS) and conventional stenting (CS) on post-procedural index of microcirculatory resistance (IMR) values. BACKGROUND: Direct stenting has been suggested to reduce periprocedural microcirculatory injury compared with stenting that follows pre-dilation (CS). The index of microcirculatory resistance is a sensitive invasive marker of coronary microvascular resistance. METHODS: Fifty patients admitted for elective percutaneous coronary intervention (PCI) were included. All patients had stable angina (Canadian Cardiovascular Society class <IV) related to a lesion suitable for DS and were randomized to DS (n = 25) or CS (n = 25). Baseline demographics and clinical and procedural data were comparable in both groups. An intracoronary pressure/temperature sensor-tipped guide wire was used. Thermodilution curves were obtained at baseline and during maximal hyperemia achieved by infusion of intravenous adenosine. The index of microcirculatory resistance was calculated from the ratio of the mean distal coronary pressure at maximal hyperemia to the inverse of mean hyperemic transit time. RESULTS: After otherwise-uneventful PCI, patients treated with CS had significantly greater IMR (DS 13 +/- 3, CS 24 +/- 14; p < 0.01) and tended to have greater post-PCI troponin T values (DS 0.035 +/- 0.04, CS 0.17 +/- 0.02; p = 0.07). In the whole sample, 20% of patients had post-PCI troponin release (troponin T >0.03 ng/ml). Patients with troponin elevation had significantly greater post-PCI IMR values than patients without troponin elevation: 24.7 +/- 13.2 versus 16.9 +/- 10.2; p = 0.04. CONCLUSIONS: In patients undergoing successful coronary stenting for stable angina, DS is associated with reduced microvascular dysfunction induced by PCI as compared with CS.
Authors: A Kalayci; V Oduncu; C Y Karabay; A Erkol; A C Tanalp; I H Tanboga; O Candan; C Gecmen; I A Izgi; C Kirma Journal: Herz Date: 2017-06-14 Impact factor: 1.443
Authors: Olivier Muller; Jozef Bartunek; Michalis Hamilos; Catalina Trana Berza; Fabio Mangiacapra; Argyrios Ntalianis; Kristof Vercruysse; Christian Duby; William Wijns; Bernard De Bruyne; Guy R Heyndrickx; Marc Vanderheyden; Josefin-Beate Holz; Emanuele Barbato Journal: J Cardiovasc Transl Res Date: 2012-12-12 Impact factor: 4.132
Authors: Jozef Bartunek; Emanuele Barbato; Guy Heyndrickx; Marc Vanderheyden; William Wijns; Josefin-Beate Holz Journal: J Cardiovasc Transl Res Date: 2013-01-11 Impact factor: 4.132
Authors: Arturo Giordano; Michele Polimeno; Nicola Corcione; Luciano Fattore; Luigi Di Lorenzo; Giuseppe Biondi-Zoccai; Paolo Ferraro; Maria Fiammetta Romano Journal: Curr Cardiol Rev Date: 2012-02