Impaired myocardial perfusion score and inflammatory markers in patients undergoing primary angioplasty for acute myocardial infarction
Arch. cardiol. Méx
; 76(4): 376-382, oct.-dic. 2006.
Article
in English
| LILACS
| ID: lil-568612
Responsible library:
BR1.1
ABSTRACT
BACKGROUND:
Microcirculatory dysfunction during acute myocardial infarction is mediated by various mechanisms including inflammation, thrombus, or plaque embolization. We hypothesize that patients with acute myocardial infarction and admission Thrombolysis in Myocardial Infarction (TIMI) myocardial perfusion grade (TMP) < 2 had increased inflammatory status as measured by high sensitivity C-reactive protein (hs-CRP).METHODS:
From January 2002 to December 2003, 166 patients (178 lesions) were referred for primary percutaneous coronary intervention. Patients were stratified based on pre-PCI TMP < 2 or TMP 2. Univariate and multivariate predictors of in-hospital and 30-day death were determined with logistic regression.RESULTS:
Pre-PCI TMP < 2 was found in 66% vs 34% with TMP 2 (P < .001). Hs-CRP levels were high in both groups but not significantly different (37.9 +/- 6 vs 33.7 +/- 6 mg/L, P = .63). Patients with TMP < 2 had higher WBC (12.83 +/-4.55 x 10(-3) vs 10.83 +/- 3.00 x 10(-3), P = .04), lower ejection fraction (40 +/- 11% vs 46 +/- 12%, P < .001), and higher admission CK-MB levels (116 +/- 13 ng/mL vs 55 +/- 13 ng/mL, P = .006). Death occurred in 12% in the poorTMP group vs 1.8% in the good TMP group (P = .03). Advanced age, use of an intra-aortic balloon pump, and elevated admission WBC were independently associated with in-hospital and 30-day death.CONCLUSIONS:
High hs-CRP levels were not associated with impaired myocardial perfusion score. Microcirculatory impairment may be related to an increased inflammatory process, independent from high hs-CRP levels.
Full text:
Available
Collection:
International databases
Health context:
SDG3 - Target 3.4 Reduce premature mortality due to noncommunicable diseases
Health problem:
Cardiovascular Disease
/
Ischemic Heart Disease
Database:
LILACS
Main subject:
Ticlopidine
/
Immunoglobulin Fab Fragments
/
Platelet Aggregation Inhibitors
/
Angioplasty, Balloon, Coronary
/
Aspirin
/
Platelet Glycoprotein GPIIb-IIIa Complex
/
Coronary Circulation
/
Fibrinolytic Agents
/
Inflammation
/
Antibodies, Monoclonal
Type of study:
Etiology study
/
Evaluation study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Aged
/
Female
/
Humans
/
Male
Language:
English
Journal:
Arch. cardiol. Méx
Journal subject:
Cardiology
Year:
2006
Document type:
Article
Affiliation country:
Mexico
/
United States
Institution/Affiliation country:
Cleveland Clinic Foundation/US
/
Instituto Nacional de Cardiología/MX