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      Factors associated with microvascular occlusion in patients with ST elevation myocardial infarction after primary percutaneous coronary intervention

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          Abstract

          Objective

          This study aimed to determine predictors of microvascular occlusion (MVO) in patients with ST elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention (pPCI).

          Methods

          This retrospective, observational study consecutively included 113 patients with STEMI undergoing pPCI. Cardiac magnetic resonance imaging was used to determine the presence of MVO in these patients. Biomarkers in serum were routinely tested 1 day after pPCI. Multivariable logistic regression analysis was used to evaluate significant predictors of occurrence of MVO.

          Results

          There were 62 patients in the MVO group and 51 patients in the non-MVO group. C-reactive protein (CRP), thrombomodulin, lymphatic vessel endothelial hyaluronan receptor-1, syndecan-1, and troponin T (TnT) levels after the procedure were significantly higher in the MVO group than in the non-MVO group. CRP (hazard ratio [HR]=1.036), TnT (HR=1.316), and syndecan-1 (HR=1.986) levels were independently associated with MVO in patients with acute myocardial infarction after pPCI.

          Conclusions

          Levels of CRP, TnT, and syndecan-1 can be used as serum biomarkers for MVO in patients with STEMI receiving pPCI.

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          Most cited references25

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          Mortality after coronary artery bypass grafting versus percutaneous coronary intervention with stenting for coronary artery disease: a pooled analysis of individual patient data

          Stuart Head, Milan Milojevic, Joost Daemen … (2018)
          Article 0 comments Cited 149 times – based on 0 reviews     Review now
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            Universal definition of myocardial infarction.

            Kristian Thygesen, Joseph Alpert, Harvey White (2007)
            Article 0 comments Cited 137 times – based on 0 reviews     Review now
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              Coronary microvascular dysfunction, microvascular angina, and treatment strategies.

              Mark A Marinescu, Adrián I Löffler, Michelle Ouellette … (2015)
              Angina without coronary artery disease (CAD) has substantial morbidity and is present in 10% to 30% of patients undergoing angiography. Coronary microvascular dysfunction (CMD) is present in 50% to 65% of these patients. The optimal treatment of this cohort is undefined. We performed a systematic review to evaluate treatment strategies for objectively-defined CMD in the absence of CAD. We included studies assessing therapy in human subjects with angina and coronary flow reserve or myocardial perfusion reserve <2.5 by positron emission tomography, cardiac magnetic resonance imaging, dilution methods, or intracoronary Doppler in the absence of coronary artery stenosis ≥50% or structural heart disease. Only 8 papers met the strict inclusion criteria. The papers were heterogeneous, using different treatments, endpoints, and definitions of CMD. The small sample sizes severely limit the power of these studies, with an average of 11 patients per analysis. Studies evaluating sildenafil, quinapril, estrogen, and transcutaneous electrical nerve stimulation application demonstrated benefits in their respective endpoints. No benefit was found with L-arginine, doxazosin, pravastatin, and diltiazem. Our systematic review highlights that there is little data to support therapies for CMD. We assess the data meeting rigorous inclusion criteria and review the related but excluded published data. We additionally describe the next steps needed to address this research gap, including a standardized definition of CMD, routine assessment of CMD in studies of chest pain without obstructive CAD, and specific therapy assessment in the population with confirmed CMD.
              Article 0 comments Cited 101 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Int Med Res
                Journal ID (iso-abbrev): J Int Med Res
                Journal ID (publisher-id): IMR
                Journal ID (hwp): spimr
                Title: The Journal of International Medical Research
                Publisher: SAGE Publications (Sage UK: London, England )
                ISSN (Print): 0300-0605
                ISSN (Electronic): 1473-2300
                Publication date (Electronic): 22 June 2021
                Publication date Collection: June 2021
                Volume: 49
                Issue: 6
                Electronic Location Identifier: 03000605211024490
                Affiliations
                [1-03000605211024490]Department of Cardiology, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, China
                Author notes
                [*]Biao Xu, Department of Cardiology, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, No. 321 Zhongshan Road, Nanjing 210008, China. Email: xubiao62@ 123456nju.edu.cn
                Author information
                https://orcid.org/0000-0001-8211-6805
                Article
                Publisher ID: 10.1177_03000605211024490
                DOI: 10.1177/03000605211024490
                PMC ID: 8236804
                PubMed ID: 34154432
                SO-VID: de1ce055-8526-433c-b61e-01af6d2495ed
                Copyright © © The Author(s) 2021
                License:

                Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                Date received : 25 February 2021
                Date accepted : 20 May 2021
                Categories
                Subject: Retrospective Clinical Research Report
                Custom metadata
                typesetter ts2

                Keywords: microvascular occlusion,st elevation myocardial infarction,c-reactive protein,troponin t,syndecan-1,primary percutaneous coronary intervention
                Data availability:
                Keywords: microvascular occlusion, st elevation myocardial infarction, c-reactive protein, troponin t, syndecan-1, primary percutaneous coronary intervention

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