Vol 60, No 5 (2004)
Other
Published online: 2005-12-12
Submitted: 2012-12-28
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Prognostic value of angiographic markers of myocardial reperfusion in patients treated with primary coronary angioplasty for anterior wall acute myocardial infarction

Aleksander Araszkiewicz, Maciej Lesiak, Stefan Grajek, Andrzej Cieśliński
Kardiol Pol 2004;60(5):451-453.
Vol 60, No 5 (2004)
Other
Published online: 2005-12-12
Submitted: 2012-12-28

Abstract

Background: Modern therapy of acute myocardial infarction (AMI) is aimed at rapid and persisting restoration of blood flow in an infarct-related artery (IRA). However, in some patients myocardial reperfusion is not achieved in spite of effective IRA recanalisation. Myocardial Blush Grade (MBG) is one of the angiographic markers useful for the detection of this phenomenon.
Aim: To assess the prognostic value of MBG in patients with anterior AMI treated with primary angioplasty.
Methods: The study group consisted of 104 patients (74 males, 30 females, mean age 62±13 years) treated with primary angioplasty due to anterior ST-segment elevation AMI. MBG was assessed after the procedure. The mortality and major cardiovascular event (MACE) rates were analysed one and six months after AMI.
Results: Patients with preserved myocardial reperfusion following angioplasty (MBG 2-3, n=64 (61.5%)) had a trend towards lower one-month mortality and significantly reduced six-month mortality compared with 40 (38.5%) patients with an impaired (MBG 0-1) myocardial reperfusion (3% vs 12.5%, NS; and 6.25% vs 20%, p<0.05, respectively). The rate of MACE was significantly lower in patients with rather than without reperfusion both after one and six months of follow-up (9.4% vs 27.5%, p=0.027 and 12.5% vs 42.5%, p<0.001, respectively). Compared with patients with a high MBG score, patients with altered reperfusion more frequently had diabetes (30% vs 12.5%, p=0.04), hypertension (67.5% vs 45%, p=0.043), longer time from the onset of symptoms to balloon inflation (355.9±199 min vs 215.5±113 min, p<0.001) and lower left ventricular ejection fraction, measured 3 days after AMI (43.3%±8 vs 47.4%±9, p=0.02).
Conclusions: MBG has a significant prognostic value in patients with anterior AMI treated with primary angioplasty. Diabetes, hypertension and long delay of treatment are associated with the impairment of myocardial reperfusion.

Abstract

Background: Modern therapy of acute myocardial infarction (AMI) is aimed at rapid and persisting restoration of blood flow in an infarct-related artery (IRA). However, in some patients myocardial reperfusion is not achieved in spite of effective IRA recanalisation. Myocardial Blush Grade (MBG) is one of the angiographic markers useful for the detection of this phenomenon.
Aim: To assess the prognostic value of MBG in patients with anterior AMI treated with primary angioplasty.
Methods: The study group consisted of 104 patients (74 males, 30 females, mean age 62±13 years) treated with primary angioplasty due to anterior ST-segment elevation AMI. MBG was assessed after the procedure. The mortality and major cardiovascular event (MACE) rates were analysed one and six months after AMI.
Results: Patients with preserved myocardial reperfusion following angioplasty (MBG 2-3, n=64 (61.5%)) had a trend towards lower one-month mortality and significantly reduced six-month mortality compared with 40 (38.5%) patients with an impaired (MBG 0-1) myocardial reperfusion (3% vs 12.5%, NS; and 6.25% vs 20%, p<0.05, respectively). The rate of MACE was significantly lower in patients with rather than without reperfusion both after one and six months of follow-up (9.4% vs 27.5%, p=0.027 and 12.5% vs 42.5%, p<0.001, respectively). Compared with patients with a high MBG score, patients with altered reperfusion more frequently had diabetes (30% vs 12.5%, p=0.04), hypertension (67.5% vs 45%, p=0.043), longer time from the onset of symptoms to balloon inflation (355.9±199 min vs 215.5±113 min, p<0.001) and lower left ventricular ejection fraction, measured 3 days after AMI (43.3%±8 vs 47.4%±9, p=0.02).
Conclusions: MBG has a significant prognostic value in patients with anterior AMI treated with primary angioplasty. Diabetes, hypertension and long delay of treatment are associated with the impairment of myocardial reperfusion.
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Keywords

acute myocardial infarction myocardial blush grade - primary angioplasty - prognosis

About this article
Title

Prognostic value of angiographic markers of myocardial reperfusion in patients treated with primary coronary angioplasty for anterior wall acute myocardial infarction

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 60, No 5 (2004)

Pages

451-453

Published online

2005-12-12

Bibliographic record

Kardiol Pol 2004;60(5):451-453.

Keywords

acute myocardial infarction myocardial blush grade - primary angioplasty - prognosis

Authors

Aleksander Araszkiewicz
Maciej Lesiak
Stefan Grajek
Andrzej Cieśliński

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