Thrombolysis

Research from S. Yoshida and co-authors reveals new findings on heart attack

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"The goal of this study was to investigate the factors related to the amount of myocardial salvage after emergent PCI in patients with ST-elevation acute MI by incorporating pre- and post-treatment indices and adjunctive treatments. Technetium-99m myocardial imaging was performed before, immediately after, and one month after emergent PCI in 161 patients with ST-elevation acute MI, and the defect score was serially evaluated. A good myocardial salvage was defined as a parts per thousand yen4 change (before minus immediately after PCI) of the defect score. Good myocardial salvage was observed in 89 patients. Based on nine clinical variables, logistic regression analysis was performed to determine the important variables related to myocardial salvage. Multivariate analysis revealed that earlier time from onset to PCI (chi (2) = 6.55, P = 0.01, odds ratio = 2.78), larger defect score before PCI (chi (2) = 7.29, P = 0.01, odds ratio = 1.13) and administration of nicorandil before PCI (chi (2) = 9.88, P = 0.008, odds ratio = 4.42) were independently associated with good myocardial salvage. Thrombolysis In Myocardial Infarction (TIMI) flow grade < 2 before PCI (chi (2) = 4.91, P = 0.03, odds ratio = 0.36) and TIMI flow grade a parts per thousand currency sign2 after PCI (chi (2) = 4.82, P = 0.03, odds ratio = 0.31) were independently associated with poor myocardial salvage. In contrast, the number of asynergic segments before PCI, infarct-related artery, adequate collaterals before PCI and stent implantation were not determinants of myocardial salvage. This study demonstrated that patients with a greater improvement of Tc-99m tetrofosmin myocardial uptake immediately after PCI had better recovery of left ventricular function and smaller final infarct size," wrote S. Yoshida and colleagues.

The researchers concluded: "Reperfusion time and TIMI flow grade a parts per thousand currency sign2 after PCI were important determinants of myocardial salvage, and nicorandil was a major determinant of myocardial salvage."

Yoshida and colleagues published their study in Annals of Nuclear Medicine (Factors associated with myocardial salvage immediately after emergent percutaneous coronary intervention in patients with ST-elevation acute myocardial infarction. Annals of Nuclear Medicine, 2009;23(4):383-390).

For additional information, contact S. Yoshida, Kansai Mededical University, Center Cardiovascular, 2-3-1 Shinmachi, Osaka 5731191, Japan.

Publisher contact information for the journal Annals of Nuclear Medicine is: Springer, 233 Spring St., New York, NY 10013, USA.

Keywords: Japan, Shinmachi, Heart Attack, Myocardial Infarction, Nuclear Medicine.

This article was prepared by Cardiovascular Business Week editors from staff and other reports. Copyright 2009, Cardiovascular Business Week via NewsRx.com.