Synapse
⌘+K
Synapse
PulseExploreClubsResearchersJournals
Instagram
HomeClubsExplore
January 1, 2016Journal of Cardiovascular Magnetic ResonanceOpen Access

Infarct size following complete revascularization in patients presenting with STEMI: a comparison of immediate and staged in-hospital non-infarct related artery PCI subgroups in the CvLPRIT study

View Full Paper
Ask AI
Bookmark
Share

Why the study?

Does immediate complete revascularization reduce infarct size and improve left ventricular function compared to staged in-hospital complete revascularization in patients with STEMI and multivessel disease?

Population

93 patients presenting with STEMI and multivessel coronary disease undergoing primary percutaneous…

Comparison

Immediate complete revascularization during the… vs Staged in-hospital complete revascularization

Design

Cohort, Original trial was randomized, but this specific comparison is based…

Follow-up

Median 2 and 4 days (pre-discharge)

Authors

JKJamal Nasir KhanUniversity Hospitals Coventry and Warwickshire NHS TrustSNSheraz A. NazirWarwickshire CollegeJGJohn P. GreenwoodCardiac Imaging

Discussion

Loading...

Member takes

Implication

Immediate complete revascularization may link to smaller infarcts and higher LVEF in STEMI multivessel disease; leaves open whether selection bias drives the association.

Structured PICO

Does immediate complete revascularization reduce infarct size and improve left ventricular function compared to staged in-hospital complete revascularization in patients with STEMI and multivessel disease?

P
Population
93 patients presenting with STEMI and multivessel coronary disease undergoing primary percutaneous intervention (PPCI) who were randomized to the complete revascularization arm of the CvLPRIT study and completed a pre-discharge CMR scan.
I
Intervention
Immediate complete revascularization during the index PPCI procedure
C
Comparator
Staged in-hospital complete revascularization (decision to stage was at the discretion of the treating interventional cardiologist)
O
Outcome
Infarct size and left ventricular ejection fraction assessed by pre-discharge Cardiovascular Magnetic Resonance (CMR) scansurrogate

Immediate complete revascularization in STEMI patients with multivessel disease is associated with smaller infarct size and better LV function compared to staged procedures, though this finding may be influenced by operator selection bias.

Limitations

  • Post-hoc analysis
  • Non-randomized comparison (decision to stage was at operator discretion)
  • Significant baseline and procedural differences between groups (confounding by indication)

Cite This Study

Khan et al. (2016) studied this question.

synapsesocial.com/papers/6a853fdf9be126273dd97a1ehttps://doi.org/10.1186/s12968-016-0298-2

Topics

Coronary artery diseasePercutaneous coronary interventionSTEMI managementChronic total occlusion PCI
View Full Paper
Ask AI
Bookmark
Share

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Changes in collateral channel filling immediately after controlled coronary artery occlusion by an angioplasty balloon in human subjects1985 · 1,516 citations
  2. 2Complete Versus Lesion-Only Primary PCI2015 · 61 citations
  3. 3Angiographic estimates of myocardium at risk during acute myocardial infarction: validation study using cardiac magnetic resonance imaging2007 · 167 citations
  4. 4Significance of Periprocedural Myonecrosis on Outcomes After Percutaneous Coronary Intervention2008 · 177 citations
  5. 5Universal definition of myocardial infarction: Kristian Thygesen, Joseph S. Alpert and Harvey D. White on behalf of the Joint ESC/ACCF/AHA/WHF Task Force for the Redefinition of Myocardial Infarction2007 · 2,546 citations