Risk Factors of Reperfusion Failure following Primary Angioplasty for ST-Segment Elevation Myocardial Infarction (STEMI)
Background: Although percutaneous coronary intervention (PCI) improves outcomes compared to thrombolysis, a substantial number of ST-elevation myocardial infarction (STEMI) patients do not achieve optimal myocardial reperfusion. This study was designed to evaluate factors related to subopt...
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| Format: | Article |
| Language: | English |
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Tehran University of Medical Sciences
2015-10-01
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| Series: | Journal of Tehran University Heart Center |
| Subjects: | |
| Online Access: | https://jthc.tums.ac.ir/index.php/jthc/article/view/299 |
| _version_ | 1824045612563169280 |
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| author | HamidReza Sanati MohammadParsa Mahjoob Ali Zahedmehr Farshad Shakerian-Ghahferokhi Ata Firoozi Reza Kiani Zohreh Sadeghi Abolfath Alizadeh-Diz Hooman Bakhshandeh-Abkenar |
| author_facet | HamidReza Sanati MohammadParsa Mahjoob Ali Zahedmehr Farshad Shakerian-Ghahferokhi Ata Firoozi Reza Kiani Zohreh Sadeghi Abolfath Alizadeh-Diz Hooman Bakhshandeh-Abkenar |
| author_sort | HamidReza Sanati |
| collection | DOAJ |
| description | Background: Although percutaneous coronary intervention (PCI) improves outcomes compared to thrombolysis, a substantial number of ST-elevation myocardial infarction (STEMI) patients do not achieve optimal myocardial reperfusion. This study was designed to evaluate factors related to suboptimal myocardial reperfusion after primary PCI in patients with STEMI.
Methods: Totally, 155 patients (124 men; mean age = 56.6 ± 11.03 years, range = 31- 85 years) with STEMI undergoing primary PCI were retrospectively studied. Additionally, the relationships between the occurrence of reperfusion failure and variables such as age, sex, cardiac risk factors, family history, Body Mass Index, time of symptom onset, ejection fraction, previous PCI, coronary artery bypass graft surgery or previous myocardial infarction, and angiographic data were analyzed. Results: Procedural success was 97.1% and complete ST resolution occurred in 43.2%. Age; cardiac risk factors; family history; body mass index; previous MI, coronary artery bypass graft surgery, or PCI; and use of thrombectomy device and GPIIb/IIIa inhibitor were not the determining factors (p value > 0.05). According to our multivariate analysis, time of symptom onset (OR [95% CI]: 045 [0.2 to 0.98]; p value = 0.044) and ejection fraction (OR [95% CI]:0.37 [0.26 to .091]; p value = 0.050) had reverse and male gender had direct significant associations with failed reperfusion (OR [95%CI]:0.34 [0.11 to 1.08]; p value = 0.068). More degrees of ST resolution occurred when the right coronary artery was the culpritvessel (p value = 0.001). The presence of more than three cardiac risk factors was associated with failed reperfusion (p value= 0.050).
Conclusion: Considering the initial risk profile of patients with acute STEMI, including time of symptom onset and ejection fraction, as well as the accumulation of cardiac risk factors in a given patient, we could predict failed myocardial reperfusion to design a more aggressive therapeutic strategy. |
| first_indexed | 2024-12-23T00:27:23Z |
| format | Article |
| id | doaj.art-497cdfefae33452d9a4db05c13922521 |
| institution | Directory Open Access Journal |
| issn | 1735-8620 2008-2371 |
| language | English |
| last_indexed | 2024-12-23T00:27:23Z |
| publishDate | 2015-10-01 |
| publisher | Tehran University of Medical Sciences |
| record_format | Article |
| series | Journal of Tehran University Heart Center |
| spelling | doaj.art-497cdfefae33452d9a4db05c139225212022-12-21T18:07:03ZengTehran University of Medical SciencesJournal of Tehran University Heart Center1735-86202008-23712015-10-0183295Risk Factors of Reperfusion Failure following Primary Angioplasty for ST-Segment Elevation Myocardial Infarction (STEMI)HamidReza Sanati0MohammadParsa Mahjoob1Ali Zahedmehr2Farshad Shakerian-Ghahferokhi3Ata Firoozi4Reza Kiani5Zohreh Sadeghi6Abolfath Alizadeh-Diz7Hooman Bakhshandeh-Abkenar8Cardiovascular Intervention Research Center, Shaheed Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.Cardiovacsular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Cardiovascular Intervention Research Center, Shaheed Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.Cardiovascular Intervention Research Center, Shaheed Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.Cardiovascular Intervention Research Center, Shaheed Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.Cardiovascular Intervention Research Center, Shaheed Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.Cardiovascular Intervention Research Center, Shaheed Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.Cardiac Electrophysiology Research Center, Shaheed Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.Cardiovascular Intervention Research Center, Shaheed Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.Background: Although percutaneous coronary intervention (PCI) improves outcomes compared to thrombolysis, a substantial number of ST-elevation myocardial infarction (STEMI) patients do not achieve optimal myocardial reperfusion. This study was designed to evaluate factors related to suboptimal myocardial reperfusion after primary PCI in patients with STEMI. Methods: Totally, 155 patients (124 men; mean age = 56.6 ± 11.03 years, range = 31- 85 years) with STEMI undergoing primary PCI were retrospectively studied. Additionally, the relationships between the occurrence of reperfusion failure and variables such as age, sex, cardiac risk factors, family history, Body Mass Index, time of symptom onset, ejection fraction, previous PCI, coronary artery bypass graft surgery or previous myocardial infarction, and angiographic data were analyzed. Results: Procedural success was 97.1% and complete ST resolution occurred in 43.2%. Age; cardiac risk factors; family history; body mass index; previous MI, coronary artery bypass graft surgery, or PCI; and use of thrombectomy device and GPIIb/IIIa inhibitor were not the determining factors (p value > 0.05). According to our multivariate analysis, time of symptom onset (OR [95% CI]: 045 [0.2 to 0.98]; p value = 0.044) and ejection fraction (OR [95% CI]:0.37 [0.26 to .091]; p value = 0.050) had reverse and male gender had direct significant associations with failed reperfusion (OR [95%CI]:0.34 [0.11 to 1.08]; p value = 0.068). More degrees of ST resolution occurred when the right coronary artery was the culpritvessel (p value = 0.001). The presence of more than three cardiac risk factors was associated with failed reperfusion (p value= 0.050). Conclusion: Considering the initial risk profile of patients with acute STEMI, including time of symptom onset and ejection fraction, as well as the accumulation of cardiac risk factors in a given patient, we could predict failed myocardial reperfusion to design a more aggressive therapeutic strategy.https://jthc.tums.ac.ir/index.php/jthc/article/view/299Myocardial infarction • Myocardial reperfusion • Electrocardiography |
| spellingShingle | HamidReza Sanati MohammadParsa Mahjoob Ali Zahedmehr Farshad Shakerian-Ghahferokhi Ata Firoozi Reza Kiani Zohreh Sadeghi Abolfath Alizadeh-Diz Hooman Bakhshandeh-Abkenar Risk Factors of Reperfusion Failure following Primary Angioplasty for ST-Segment Elevation Myocardial Infarction (STEMI) Journal of Tehran University Heart Center Myocardial infarction • Myocardial reperfusion • Electrocardiography |
| title | Risk Factors of Reperfusion Failure following Primary Angioplasty for ST-Segment Elevation Myocardial Infarction (STEMI) |
| title_full | Risk Factors of Reperfusion Failure following Primary Angioplasty for ST-Segment Elevation Myocardial Infarction (STEMI) |
| title_fullStr | Risk Factors of Reperfusion Failure following Primary Angioplasty for ST-Segment Elevation Myocardial Infarction (STEMI) |
| title_full_unstemmed | Risk Factors of Reperfusion Failure following Primary Angioplasty for ST-Segment Elevation Myocardial Infarction (STEMI) |
| title_short | Risk Factors of Reperfusion Failure following Primary Angioplasty for ST-Segment Elevation Myocardial Infarction (STEMI) |
| title_sort | risk factors of reperfusion failure following primary angioplasty for st segment elevation myocardial infarction stemi |
| topic | Myocardial infarction • Myocardial reperfusion • Electrocardiography |
| url | https://jthc.tums.ac.ir/index.php/jthc/article/view/299 |
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