Key result
Adequate right ventricular tissue reperfusion post-PCI was associated with significantly lower mean peak CK-MB compared to impaired reperfusion (197 vs. 305 U/L, P=0.021).
Why the study?
Evaluation of myocardial tissue reperfusion of the right ventricle in patients treated with PCI for inferior STEMI with right ventricular infarction had not yet been made.
What is the rate of impaired right ventricular tissue reperfusion assessed by ST-segment analysis in patients with inferior STEMI and RVI treated with primary PCI?
Observational (n=456)
What is the rate of impaired right ventricular tissue reperfusion assessed by ST-segment analysis in patients with inferior STEMI and RVI treated with primary PCI?
Absolute Event Rate: 197% vs 305%
p-value: p=0.021
Impaired right ventricular reperfusion occurs in over a third of patients with inferior STEMI and RVI after primary PCI, highlighting the need for specific RV ST-segment analysis.
RV reperfusion assessment may refine risk stratification post-PCI in inferior STEMI; extends LV-focused reperfusion data to the right ventricle.
BACKGROUND: Impaired myocardial tissue reperfusion affects prognosis of patients with ST-segment elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention (PCI) and can be identified by ST-segment analysis. To date, evaluation of the myocardial tissue reperfusion of the right ventricle (RV) among the patients treated with PCI for inferior STEMI with right ventricular infarction (RVI) has not been made yet. METHODS: Patients with inferior STEMI were screened for RVI. Tissue reperfusion was evaluated by maximal residual ST-segment deviation post PCI, independently for the RV and for inferior wall. Myocardial injury was assessed by the peak creatine kinase-mb (CK-MB) value. RESULTS: Among 456 patients with inferior STEMI, concomitant RVI occurred in 153 (33.5%) subjects (59.86±10.35 years old, 71.9% females). Tissue reperfusion of LV was present in 75 (49%), whereas 55 (35.9%) had both successful LV and RV reperfusion. Among 97 (63.4%) with successful tissue reperfusion of RV, 55 (56.7%) had associated successful tissue reperfusion of inferior wall. Adequate LV reperfusion was accompanied by RV in over 73.3% of patients (P=0.006). Mean peak CK-MB was lower in the group with adequate versus impaired RV tissue-perfusion (197±143 vs. 305±199 U/L, P=0.021 respectively). CONCLUSIONS: Impaired reperfusion of RV is observed in more than one third of inferior STEMIs with RVI and is not strictly associated with impaired reperfusion of inferior wall and clinical or angiographic variables, therefore ST-segment analysis for RV is mandatory.
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Świerczewski et al. (2020) conducted an observational in Inferior STEMI with right ventricular infarction (n=456). Adequate right ventricular tissue reperfusion vs. Impaired right ventricular tissue reperfusion was evaluated on Peak creatine kinase-mb (CK-MB) value (p=0.021). Adequate right ventricular tissue reperfusion post-PCI was associated with significantly lower mean peak CK-MB compared to impaired reperfusion (197 vs. 305 U/L, P=0.021).
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