Search: (WFRF:(Storey Robert F.)) srt2:(2020-2022) pers:(Kunadian Vijay) >
Effects of early my...
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Batra, GoravUppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi
(author)
Effects of early myocardial reperfusion and perfusion on myocardial necrosis/dysfunction and inflammation in patients with ST-segment and non-ST-segment elevation acute coronary syndrome : results from the PLATelet inhibition and patients Outcomes (PLATO) trial
- Article/chapterEnglish2022
Publisher, publication year, extent ...
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2022-02-25
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Oxford University Press,2022
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electronicrdacarrier
Numbers
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LIBRIS-ID:oai:DiVA.org:uu-483781
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-483781URI
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https://doi.org/10.1093/ehjacc/zuac020DOI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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Aims Restoration of myocardial blood flow and perfusion during percutaneous coronary intervention (PCI) measured using Thrombolysis in Myocardial Infarction (TIMI) flow grade (TFG) and perfusion grade (TMPG) is associated with improved outcomes in acute coronary syndrome (ACS). Associations between TFG/TMPG and changes in biomarkers reflecting myocardial damage/dysfunction and inflammation is unknown. Methods and results Among 2606 patients included, TFG was evaluated in 2198 and TMPG in 1874 with ST-segment elevation myocardial infarction (STEMI) or non-ST-segment ACS (NSTE-ACS). Biomarkers reflecting myocardial necrosis [troponin T (TnT)], myocardial dysfunction [N-terminal prohormone brain natriuretic peptide (NT-proBNP)], inflammation [interleukin-6 (IL-6) and C-reactive protein (CRP)], and oxidative stress/ageing/inflammation [growth differentiation factor-15 (GDF-15)] were measured at baseline, discharge, and 1- and 6-month post-randomization. Associations between TFG/TMPG and changes in biomarker levels were evaluated using the Mann-Whitney-Wilcoxon signed test. In total, 1423 (54.6%) patients had STEMI and 1183 (45.4%) NSTE-ACS. Complete reperfusion after PCI with TFG = 3 was achieved in 1110 (85.3%) with STEMI and in 793 (88.5%) with NSTE-ACS. Normal myocardial perfusion with TMPG = 3 was achieved in 475 (41.6%) with STEMI and in 396 (54.0%) with NSTE-ACS. Levels of TnT, NT-proBNP, IL-6, CRP, and GDF-15 were substantially lower at discharge in patients with complete vs. incomplete TFG and STEMI (P < 0.01). This pattern was not observed for patients with NSTE-ACS. Patients with normal vs. abnormal TMPG and NSTE-ACS had lower levels of NT-proBNP at discharge (P = 0.01). Conclusions Successful restoration of epicardial blood flow in STEMI was associated with less myocardial necrosis/dysfunction and inflammation. Attainment of normal myocardial perfusion was associated with less myocardial dysfunction in NSTE-ACS.
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Renlund, Henrik,1979-Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)(Swepub:uu)henre358
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Kunadian, VijayNewcastle Univ, Fac Med Sci, Translat & Clin Res Inst, Newcastle Upon Tyne, Tyne & Wear, England.;Newcastle Upon Tyne Hosp NHS Fdn Trust, Freeman Hosp, Cardiothorac Ctr, Newcastle Upon Tyne, Tyne & Wear, England.
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James, Stefan K.,1964-Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)(Swepub:uu)stjam367
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Storey, Robert F.Univ Sheffield, Dept Infect Immun & Cardiovasc Dis, Sheffield, S Yorkshire, England.
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Steg, P. GabrielUniv Paris, Hop Bichat, AP HP, French Alliance Cardiovasc Trials, Paris, France.;INSERM, U1148, Paris, France.
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Katus, Hugo A.Univ Klinikum Heidelberg, Med Klin, Heidelberg, Germany.
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Harrington, Robert A.Stanford Univ, Dept Med, Stanford, CA 94305 USA. Beth Israel Deaconess Med Ctr, Harvard Med Sch, Dept Med, Cardiovasc Div, Boston, MA USA. Grochowski Hosp, Ctr Postgrad Med Educ, Dept Cardiol, Warsaw, Poland.
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Gibson, C. MichaelUppsala universitet,Klinisk kemi
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Budaj, AndrzejCenter of Postgraduate Medical Education, Grochowski Hospital, Warsaw, Poland
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Siegbahn, Agneta,1947-Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)(Swepub:uu)agsie424
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Wallentin, Lars,1943-Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)(Swepub:uu)larswall
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Uppsala universitetUppsala kliniska forskningscentrum (UCR)
(creator_code:org_t)
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In:European Heart Journal: Oxford University Press11:4, s. 336-3492048-87262048-8734
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