Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Ischemia from Nonculprit Stenoses Is Not Associated with Reduced Culprit Infarct Size in Patients with ST-Segment-Elevation Myocardial Infarction

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Patient-Specific Computer Simulation of Transcatheter Aortic Valve Replacement in Bicuspid Aortic Valve Morphology

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Morphology and Function of the Lymphatic Vasculature in Patients With a Fontan Circulation

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Echocardiographic Predictors of Mortality in Women With Heart Failure With Reduced Ejection Fraction

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Clopidogrel, prasugrel, and ticagrelor for all-comers with ST-segment elevation myocardial infarction

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Nationwide cardiovascular disease admission rates during a second COVID-19 lockdown

    Publikation: Bidrag til tidsskriftLetterForskningpeer review

  3. Workforce Attachment after Ischemic Stroke – The Importance of Time to Thrombolytic Therapy

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Day-to-day measurement of physical activity and risk of atrial fibrillation

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Vis graf over relationer

Background: In patients with ST-segment-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention, reperfusion injury accounts for a significant fraction of the final infarct size, which is directly related to patient prognosis. In animal studies, brief periods of ischemia in noninfarct-related (nonculprit) coronary arteries protect the culprit myocardium via remote ischemic preconditioning. Positive fractional flow reserve (FFR) documents functional significant coronary nonculprit stenosis, which may offer remote ischemic preconditioning of the culprit myocardium. The aim of the study was to investigate the association between functional significant, multivessel disease (MVD) and reduced culprit final infarct size or increased myocardial salvage (myocardial salvage index [MSI]) in a large contemporary cohort of STEMI patients. Methods: Cardiac magnetic resonance was performed in 610 patients with STEMI at day 1 and 3 months after primary percutaneous coronary intervention. Patients were stratified into 3 groups according to FFR measurements in nonculprit stenosis (if any): angiographic single vessel disease (SVD), FFR nonsignificant MVD (functional SVD), or FFR-significant, functional MVD. Results: A total of 431 (71%) patients had SVD, 35 (6%) had functional SVD, and 144 (23%) had functional MVD. There was no difference in final infarct size (mean infarct size [%left ventricular mass] SVD, 9±3%; functional SVD, 9±3%; and functional MVD, 9±3% [P=0.82]) or in MSI between groups (mean MSI [%left] SVD, 66±23%; functional SVD, 68±19%; and functional MVD, 69±19% [P=0.62]). In multivariable analyses, functional MVD was not associated with larger MSI (P=0.56) or smaller infarct size (P=0.55). Conclusions: Functional MVD in nonculprit myocardium was not associated with reduced culprit final infarct size or increased MSI following STEMI. This is important knowledge for future studies examining a cardioprotective treatment in patients with STEMI, as a possible confounding effect of FFR-significant, functional MVD can be discarded. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01435408 (DANAMI 3-iPOST and DANAMI 3-DEFER) and NCT01960933 (DANAMI 3-PRIMULTI).

OriginalsprogEngelsk
TidsskriftCirculation: Cardiovascular Imaging
Vol/bind14
Udgave nummer5
Sider (fra-til)416-425
Antal sider10
ISSN1941-9651
DOI
StatusUdgivet - maj 2021

Bibliografisk note

Publisher Copyright:
© 2021 American Heart Association, Inc.

Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.

ID: 67233851