Sự thay đổi sức căng cơ tim sau can thiệp động mạch vành ở bệnh nhân hội chứng vành cấp không ST chênh lên

Q: What is the clinical evidence from this study?

Study design: RCT. Population: Heart failure after acute myocardial infarction (n=134). Intervention: Autologous bone marrow stem cell therapy vs. Standard medical therapy. Primary outcome: Combined endpoint (all-cause death, recurrent MI, revascularization, heart failure rehospitalization) (p=0.02).

Trịnh Việt Hà; Nguyễn Thị Thu Hoài; Đỗ Doãn Lợi

doi:10.58354/jvc.94.95.2021.171

January 1, 2021Tạp chí Tim Mạch Học Việt NamOpen Access

Sự thay đổi sức căng cơ tim sau can thiệp động mạch vành ở bệnh nhân hội chứng vành cấp không ST chênh lên

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Key result

Autologous bone marrow stem cell therapy cuts major cardiovascular events ~53% vs. optimal medical therapy.

P=0.02
n=134

Why the study?

To evaluate changes in myocardial strain using speckle-tracking echocardiography after coronary intervention in patients with non-ST-elevation acute coronary syndrome.

Does autologous bone marrow stem cell transplantation improve clinical outcomes and left ventricular ejection fraction in patients with heart failure after acute myocardial infarction?

Key Points

To assess changes in myocardial strain using speckle tracking echocardiography after coronary intervention in non-ST elevation ACS patients.
Analyzed 125 patients diagnosed with non-ST elevation ACS.
Conducted standard echocardiography and speckle tracking echocardiography at three time points: before the procedure, 48 hours, and 30 days post-intervention.
Measured myocardial strain parameters: global longitudinal strain (GLS), circumferential strain (GCS), radial strain (GRS).
Average age of participants was 65.5±10.5 years, with 71% male.
GLS measurements improved from -16.94±3.37% before intervention to -18.59±3.34% after 30 days (p<0.05).
Statistically significant changes in GLS were observed at both 48 hours and 30 days post-intervention.

Study Design

Type

RCT (n=134)

Randomization

Randomized

Multicenter

No

Structured PICO

Does autologous bone marrow stem cell transplantation improve clinical outcomes and left ventricular ejection fraction in patients with heart failure after acute myocardial infarction?

P

Population

134 patients with heart failure after acute myocardial infarction (AMI), successfully revascularized by primary percutaneous coronary intervention (PCI) within the first 5 days, with reduced left ventricular systolic function (LVEF 20-50%). Mean age 52.7 in the stem cell group and 56.0 in the control group, predominantly male (86.6% and 73.1%). Conducted at the Vietnam Heart Institute. Key inclusion: AMI with LAD as the culprit lesion, successful primary PCI (TIMI flow ≥ II), LVEF 20-50% at 3-5 days post-PCI. Key exclusion: mechanical complications, prior AMI, cardiogenic shock, NYHA IV before selection, severe anemia, severe comorbidities, or age >70.

I

Intervention

Autologous bone marrow stem cell transplantation via intracoronary injection into the infarct-related artery (LAD), added to optimal medical therapy.

C

Comparator

Control group receiving optimal medical therapy alone.

O

Outcome

Composite endpoint of all-cause death, recurrent myocardial infarction, repeat coronary intervention, and rehospitalization for heart failure at 12 months.composite

Main Result

Absolute Event Rate: 13.11% vs 27.87%

p-value: p=0.02

Autologous bone marrow stem cell transplantation significantly reduces heart failure rehospitalization and composite cardiovascular events at 12 months in patients with reduced LVEF after acute myocardial infarction.

Ask about this paper

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Implication

Supports serial GLS monitoring post-PCI in NSTE-ACS; extends prior evidence to real-world Vietnamese cohorts.

Abstract

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Discussion

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Cite This Study

Hà et al. (2021) conducted an RCT in Heart failure after acute myocardial infarction (n=134). Autologous bone marrow stem cell therapy vs. Standard medical therapy was evaluated on Combined endpoint (all-cause death, recurrent MI, revascularization, heart failure rehospitalization) (p=0.02). Autologous bone marrow stem cell therapy significantly reduced the combined cardiovascular endpoint to 13.11% compared to 27.87% in the control group at 12 months.

synapsesocial.com/papers/69e5c27e03c2939914028b81 https://doi.org/10.58354/jvc.94.95.2021.171

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Sự thay đổi sức căng cơ tim sau can thiệp động mạch vành ở bệnh nhân hội chứng vành cấp không ST chênh lên

Key Points

Study Design

Structured PICO

Main Result

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Sự thay đổi sức căng cơ tim sau can thiệp động mạch vành ở bệnh nhân hội chứng vành cấp không ST chênh lên

Key Points

Study Design

Structured PICO

Main Result

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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