Key result
Pressure-controlled intermittent Coronary Sinus Occlusion (PiCSO) as an adjunct to pPCI was associated with a lower infarct size at 5 days compared to controls (14.3% vs 21.2%; p=0.023).
Why the study?
The study was conducted to investigate the effects of Pressure-controlled intermittent Coronary Sinus Occlusion (PiCSO) on infarct size at 5 days after primary PCI in patients with STEMI.
Does Pressure-controlled intermittent Coronary Sinus Occlusion (PiCSO) adjunct to primary PCI reduce infarct size in patients with anterior STEMI?
Cohort (n=125)
Yes
Does Pressure-controlled intermittent Coronary Sinus Occlusion (PiCSO) adjunct to primary PCI reduce infarct size in patients with anterior STEMI?
Absolute Event Rate: 14.3% vs 21.2%
p-value: p=0.023
PiCSO as an adjunct to primary PCI in anterior STEMI significantly reduces infarct size at 5 days compared to matched controls.
PiCSO was associated with smaller infarct size in anterior STEMI; hypothesis-generating and requires randomized confirmation before practice change.
BACKGROUND: The aim of this clinical research was to investigate the effects of Pressure-controlled intermittent Coronary Sinus Occlusion (PiCSO) on infarct size at 5 days after primary percutaneous coronary intervention (pPCI) in patients with ST-segment elevation myocardial infarction (STEMI). METHODS AND RESULTS: This comparative study was carried out in four UK hospitals. Forty-five patients with anterior STEMI presenting within 12 h of symptom onset received pPCI plus PiCSO (initiated after reperfusion; n = 45) and were compared with a propensity score-matched control cohort from INFUSE-AMI (n = 80). Infarct size (% of LV mass, median [interquartile range]) measured by cardiac magnetic resonance (CMR) at day 5 was significantly lower in the PiCSO group (14.3% [95% CI 9.2-19.4%] vs. 21.2% [95% CI 18.0-24.4%]; p = 0.023). There were no major adverse cardiac events (MACE) related to the PiCSO intervention. CONCLUSIONS: PiCSO, as an adjunct to pPCI, was associated with a lower infarct size at 5 days after anterior STEMI in a propensity score-matched population.
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Egred et al. (2020) conducted a cohort in anterior STEMI (n=125). Pressure-controlled intermittent Coronary Sinus Occlusion (PiCSO) plus pPCI vs. pPCI alone (propensity score-matched control cohort) was evaluated on Infarct size (% of LV mass) measured by cardiac magnetic resonance (CMR) at day 5 (p=0.023). Pressure-controlled intermittent Coronary Sinus Occlusion (PiCSO) as an adjunct to pPCI was associated with a lower infarct size at 5 days compared to controls (14.3% vs 21.2%; p=0.023).
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