Left ventricular contractile function after distal protection in primary percutaneous coronary intervention: results from the Drug Elution and Distal Protection in ST-Elevation Myocardial Infarction trial

K F Kofoed; H Kelbæk; L Thuesen; S H Poulsen; C Hassager; N H Andersen; S Helqvist; J F Lassen; P Clemmensen; L Kløvgaard; A Kaltoft; T Engstrøm; L R Krusell; C J Terkelsen; L Køber

doi:10.1016/j.ijcard.2009.07.020

Left ventricular contractile function after distal protection in primary percutaneous coronary intervention: results from the Drug Elution and Distal Protection in ST-Elevation Myocardial Infarction trial

K F Kofoed, H Kelbæk, L Thuesen, S H Poulsen, C Hassager, N H Andersen, S Helqvist, J F Lassen, P Clemmensen, L Kløvgaard, A Kaltoft, T Engstrøm, L R Krusell, C J Terkelsen, L Køber

Abstract

BACKGROUND: Coronary intervention (PCI) may result in an increased infarct size. We evaluated the effect of distal protection during PCI for ST-segment elevation myocardial infarction (STEMI) on myocardial function.

METHODS: Patients with STEMI were randomly referred within 12 h for PCI with (N = 312) or without distal protection (N = 314). Left ventricular (LV) contractile function was assessed with echocardiography 8 months after PCI. Global LV myocardial wall motion index (WMI) was calculated as the average wall motion score of all myocardial segments. The occurrence of death, nonfatal re-infarction, and stroke 8 months after PCI were also recorded.

RESULTS: The occurrence of death, nonfatal re-infarction, and stroke 8 months after PCI was 7.1% after distal protection and 5.7% after conventional treatment (p = 0.17). WMI improved by 4.1% at 8 months in patients treated with distal protection compared to patients receiving conventional PCI (p < 0.01). In myocardium supplied by a culprit artery treated by distal protection regional LV function was 9-11% higher than myocardial regions treated conventionally ( p < 0.02).

CONCLUSIONS: Routine use of distal protection during primary PCI is associated with a significant improvement in LV contractile function, with no detectable impact on intermediate term clinical outcome.

Original language	English
Journal	International Journal of Cardiology
Volume	146
Issue number	3
Pages (from-to)	395-8
Number of pages	4
ISSN	0167-5273
DOIs	https://doi.org/10.1016/j.ijcard.2009.07.020
Publication status	Published - 3 Feb 2011
Externally published	Yes

Keywords

Angioplasty, Balloon, Coronary/methods
Humans
Myocardial Contraction
Myocardial Infarction/physiopathology
Postoperative Complications/prevention & control
Ventricular Function, Left

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Kofoed, K. F., Kelbæk, H., Thuesen, L., Poulsen, S. H., Hassager, C., Andersen, N. H., Helqvist, S., Lassen, J. F., Clemmensen, P., Kløvgaard, L., Kaltoft, A., Engstrøm, T., Krusell, L. R., Terkelsen, C. J., & Køber, L. (2011). Left ventricular contractile function after distal protection in primary percutaneous coronary intervention: results from the Drug Elution and Distal Protection in ST-Elevation Myocardial Infarction trial. International Journal of Cardiology, 146(3), 395-8. https://doi.org/10.1016/j.ijcard.2009.07.020

Left ventricular contractile function after distal protection in primary percutaneous coronary intervention: results from the Drug Elution and Distal Protection in ST-Elevation Myocardial Infarction trial. / Kofoed, K F; Kelbæk, H; Thuesen, L et al.
In: International Journal of Cardiology, Vol. 146, No. 3, 03.02.2011, p. 395-8.

Research output: Contribution to journal › Journal article › Research › peer-review

Kofoed, KF, Kelbæk, H, Thuesen, L, Poulsen, SH, Hassager, C, Andersen, NH, Helqvist, S, Lassen, JF, Clemmensen, P, Kløvgaard, L, Kaltoft, A, Engstrøm, T, Krusell, LR, Terkelsen, CJ & Køber, L 2011, 'Left ventricular contractile function after distal protection in primary percutaneous coronary intervention: results from the Drug Elution and Distal Protection in ST-Elevation Myocardial Infarction trial', International Journal of Cardiology, vol. 146, no. 3, pp. 395-8. https://doi.org/10.1016/j.ijcard.2009.07.020

Kofoed KF, Kelbæk H, Thuesen L, Poulsen SH, Hassager C, Andersen NH et al. Left ventricular contractile function after distal protection in primary percutaneous coronary intervention: results from the Drug Elution and Distal Protection in ST-Elevation Myocardial Infarction trial. International Journal of Cardiology. 2011 Feb 3;146(3):395-8. doi: 10.1016/j.ijcard.2009.07.020

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title = "Left ventricular contractile function after distal protection in primary percutaneous coronary intervention: results from the Drug Elution and Distal Protection in ST-Elevation Myocardial Infarction trial",

abstract = "BACKGROUND: Coronary intervention (PCI) may result in an increased infarct size. We evaluated the effect of distal protection during PCI for ST-segment elevation myocardial infarction (STEMI) on myocardial function.METHODS: Patients with STEMI were randomly referred within 12 h for PCI with (N = 312) or without distal protection (N = 314). Left ventricular (LV) contractile function was assessed with echocardiography 8 months after PCI. Global LV myocardial wall motion index (WMI) was calculated as the average wall motion score of all myocardial segments. The occurrence of death, nonfatal re-infarction, and stroke 8 months after PCI were also recorded.RESULTS: The occurrence of death, nonfatal re-infarction, and stroke 8 months after PCI was 7.1% after distal protection and 5.7% after conventional treatment (p = 0.17). WMI improved by 4.1% at 8 months in patients treated with distal protection compared to patients receiving conventional PCI (p < 0.01). In myocardium supplied by a culprit artery treated by distal protection regional LV function was 9-11% higher than myocardial regions treated conventionally ( p < 0.02).CONCLUSIONS: Routine use of distal protection during primary PCI is associated with a significant improvement in LV contractile function, with no detectable impact on intermediate term clinical outcome.",

keywords = "Angioplasty, Balloon, Coronary/methods, Humans, Myocardial Contraction, Myocardial Infarction/physiopathology, Postoperative Complications/prevention & control, Ventricular Function, Left",

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T1 - Left ventricular contractile function after distal protection in primary percutaneous coronary intervention

T2 - results from the Drug Elution and Distal Protection in ST-Elevation Myocardial Infarction trial

AU - Kofoed, K F

AU - Kelbæk, H

AU - Thuesen, L

AU - Poulsen, S H

AU - Hassager, C

AU - Andersen, N H

AU - Helqvist, S

AU - Lassen, J F

AU - Clemmensen, P

AU - Kløvgaard, L

AU - Kaltoft, A

AU - Engstrøm, T

AU - Krusell, L R

AU - Terkelsen, C J

AU - Køber, L

PY - 2011/2/3

Y1 - 2011/2/3

N2 - BACKGROUND: Coronary intervention (PCI) may result in an increased infarct size. We evaluated the effect of distal protection during PCI for ST-segment elevation myocardial infarction (STEMI) on myocardial function.METHODS: Patients with STEMI were randomly referred within 12 h for PCI with (N = 312) or without distal protection (N = 314). Left ventricular (LV) contractile function was assessed with echocardiography 8 months after PCI. Global LV myocardial wall motion index (WMI) was calculated as the average wall motion score of all myocardial segments. The occurrence of death, nonfatal re-infarction, and stroke 8 months after PCI were also recorded.RESULTS: The occurrence of death, nonfatal re-infarction, and stroke 8 months after PCI was 7.1% after distal protection and 5.7% after conventional treatment (p = 0.17). WMI improved by 4.1% at 8 months in patients treated with distal protection compared to patients receiving conventional PCI (p < 0.01). In myocardium supplied by a culprit artery treated by distal protection regional LV function was 9-11% higher than myocardial regions treated conventionally ( p < 0.02).CONCLUSIONS: Routine use of distal protection during primary PCI is associated with a significant improvement in LV contractile function, with no detectable impact on intermediate term clinical outcome.

AB - BACKGROUND: Coronary intervention (PCI) may result in an increased infarct size. We evaluated the effect of distal protection during PCI for ST-segment elevation myocardial infarction (STEMI) on myocardial function.METHODS: Patients with STEMI were randomly referred within 12 h for PCI with (N = 312) or without distal protection (N = 314). Left ventricular (LV) contractile function was assessed with echocardiography 8 months after PCI. Global LV myocardial wall motion index (WMI) was calculated as the average wall motion score of all myocardial segments. The occurrence of death, nonfatal re-infarction, and stroke 8 months after PCI were also recorded.RESULTS: The occurrence of death, nonfatal re-infarction, and stroke 8 months after PCI was 7.1% after distal protection and 5.7% after conventional treatment (p = 0.17). WMI improved by 4.1% at 8 months in patients treated with distal protection compared to patients receiving conventional PCI (p < 0.01). In myocardium supplied by a culprit artery treated by distal protection regional LV function was 9-11% higher than myocardial regions treated conventionally ( p < 0.02).CONCLUSIONS: Routine use of distal protection during primary PCI is associated with a significant improvement in LV contractile function, with no detectable impact on intermediate term clinical outcome.

KW - Angioplasty, Balloon, Coronary/methods

KW - Humans

KW - Myocardial Contraction

KW - Myocardial Infarction/physiopathology

KW - Postoperative Complications/prevention & control

KW - Ventricular Function, Left

U2 - 10.1016/j.ijcard.2009.07.020

DO - 10.1016/j.ijcard.2009.07.020

M3 - Journal article

C2 - 19700209

SN - 0167-5273

VL - 146

SP - 395

EP - 398

JO - International Journal of Cardiology

JF - International Journal of Cardiology

IS - 3

ER -