Key result
Late PCI after anterior MI is linked to ~68% greater apical systolic wall displacement.
Why the study?
Does late percutaneous coronary intervention improve regional left ventricular function in patients with anterior wall myocardial infarction?
Cohort (n=13)
No
Does late percutaneous coronary intervention improve regional left ventricular function in patients with anterior wall myocardial infarction?
Absolute Event Rate: 5.89% vs 3.5%
p-value: p=0.019
Late PCI for anterior STEMI significantly improves regional apical left ventricular function and global ejection fraction, suggesting a potential benefit in limiting adverse remodeling.
May improve apical LV regional function post-anterior MI; hypothesis-generating and requires randomized confirmation before practice change.
Background: Late revascularization following a myocardial infarction has questionable clinical benefit. Methods: We studied 13 patients with anterior wall myocardial infarction who underwent percutaneous coronary intervention within 2 weeks of the primary event, by quantitative analysis of 2-dimensional echocardiographic images. Endocardial segmentations of the left ventricular (LV) endocardium from the 4-chamber views were studied over time to establish cumulative wall displacements (CWDs) throughout the cardiac cycle. Results: Left ventricular end-systolic volume decreased to 42 ± 8 mL/body surface area ( P = .034) and LV ejection fraction improved to 52% ± 7% ( P = .04). Analysis of LV endocardial CWD demonstrated significant improvements in mid-systolic to late-systolic phases in the apical LV segments, from 3.5 ± 0.32 to 5.89 ± 0.43 mm ( P = .019). Improvements in CWD were also observed in the late-diastolic phase of the cardiac cycle, from 1.50 ± 0.42 to 1.76 ± 0.52 mm ( P = .04). Conclusions: In our pilot patient cohort, following late establishment of infarct-related artery patency following an anterior wall myocardial infarction, regional improvements were noted in the LV apical segments during systole and late diastole.
No takes yet. Share an insight, caveat, or question.
Adhyapak et al. (2017) conducted a cohort in Anterior wall myocardial infarction (n=13). Late percutaneous coronary intervention vs. Baseline (pre-intervention) was evaluated on Cumulative wall displacement in mid-systolic to late-systolic phases in the apical left ventricular segments (mm) (p=0.019). Late percutaneous coronary intervention following anterior wall myocardial infarction significantly improved regional cumulative wall displacement in the apical left ventricular segments during systole from 3.5 mm to 5.89 mm.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: