Key result
Distal protection during primary percutaneous coronary intervention for acute anterior STEMI significantly preserved the index of microcirculatory resistance compared to PCI without distal protection (26.6 U vs 37.2 U, p=0.03242).
Why the study?
Does a distal protection device improve the index of microcirculatory resistance in patients with acute anterior STEMI undergoing primary PCI?
RCT (n=36)
Randomized
No
Does a distal protection device improve the index of microcirculatory resistance in patients with acute anterior STEMI undergoing primary PCI?
The use of a distal protection device during primary PCI for acute anterior STEMI significantly preserves the index of microcirculatory resistance, suggesting a reduction in microvascular damage.
Supports distal protection consideration in anterior STEMI PCI; confirms IMR benefit in randomized data.
BACKGROUND: The objective of this study was to investigate whether a distal protection (DP) device can preserve the index of microcirculatory resistance (IMR) after primary percutaneous coronary intervention (PCI) in patients with anterior ST-segment elevation myocardial infarction (STEMI). METHODS AND RESULTS: The study group of 36 consecutive patients with anterior STEMI were randomized into 2 groups of primary PCI with or without DP: stenting without DP (non-DP group, n = 17) and with DP (DP group, n = 19). The DP in all cases was Filtrap (Nipro, Japan). Following final coronary angiography after successful PCI, IMR was measured using PressureWire™ Certus (St Jude Medical, USA) at maximal hyperemia. The averaged IMR of the 36 patients with STEMI after primary PCI was 31.6U. The IMR in the DP group was significantly lower than that in the non-DP group (26.6 ± 25.8U vs. 37.2 ± 23.2U, P = 0.03242). CONCLUSIONS: DP as an adjunctive therapy of PCI for acute anterior STEMI may have beneficial effects on myocardial microcirculation because of preservation of IMR.
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Ito et al. (2010) conducted an RCT in Acute anterior ST-segment elevation myocardial infarction (STEMI) (n=36). Distal protection device (Filtrap) vs. Primary PCI without distal protection was evaluated on Index of microcirculatory resistance (IMR) (p=0.03242). Distal protection during primary percutaneous coronary intervention for acute anterior STEMI significantly preserved the index of microcirculatory resistance compared to PCI without distal protection (26.6 U vs 37.2 U, p=0.03242).
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