Primary percutaneous coronary intervention in ST-elevation myocardial infarction with an ectatic infarct-related artery.

Abstract:

OBJECTIVE:The aim of this study was to describe the procedural characteristics, myocardial perfusion, and long-term outcomes in ST-elevation myocardial infarction patients with an ectatic infarct-related artery (IRA). PATIENTS AND METHODS:The retrospective analysis included 1270 consecutive ST-elevation myocardial infarction patients treated by primary percutaneous coronary intervention who were categorized according to the coronary anatomy of the IRA as follows: ectatic group (n=91) and control group (n=1179). RESULTS:Compared with the control group, patients in the ectatic group experienced lower Thombolysis in myocardial infarction grade 3 flow rate after percutaneous coronary intervention (64.8 vs. 88.2%: ectatic group vs. nonectatic group, P<0.001) and more frequent distal embolization (44.4 vs. 11.1%, P<0.001). ECG ST resolution was significantly lower in the ectatic group (P<0.001). Paradoxically, the left ventricular ejection fraction values at discharge were significantly higher in the ectatic group (P=0.032) and the infarct size assessed within 6-12 months after discharge tended to be smaller (P=0.06). The 30-day mortality rate was not significantly different between the two groups (3.3 vs. 5.0%, P=0.378) as well as Kaplan-Meier analysis for long-term overall survival in both groups (P=0.8). CONCLUSION:Patients with ectatic IRA were characterized by discrepancies between high angiographic thrombus burden in a larger vessel and impact on left ventricular function that may influence their long-term survival.

journal_name

Coron Artery Dis

journal_title

Coronary artery disease

authors

Popovic B,Agrinier N,Metzdorf PA,Camenzind E

doi

10.1097/MCA.0000000000000720

subject

Has Abstract

pub_date

2019-06-01 00:00:00

pages

277-284

issue

4

eissn

0954-6928

issn

1473-5830

journal_volume

30

pub_type

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