Key result
In stable patients with subacute anterior myocardial infarction, percutaneous coronary intervention for total occlusion was associated with significant left ventricular remodeling and a blunted decrease in cardiac biomarkers compared to medical therapy.
Why the study?
Does late PCI plus medical therapy compared to medical therapy alone improve left ventricular remodeling and cardiac biomarkers in stable patients with subacute anterior MI?
Observational (n=57)
Yes
Does late PCI plus medical therapy compared to medical therapy alone improve left ventricular remodeling and cardiac biomarkers in stable patients with subacute anterior MI?
Answers are grounded in this paper and cite their sources.
Late PCI for totally occluded infarct-related arteries after MI is associated with worse left ventricular remodeling compared to medical therapy alone, as reflected by echocardiography and cardiac biomarkers.
BACKGROUND: The purpose of this study is to evaluate the importance of tenascin-C ( TNC), N-terminal pro brain natriuretic peptide (NT-proBNP) and C-reactive protein (CRP) on LV remodelling after myocardial infarction (MI). METHODS: Fifty-seven stable patients with subacute anterior MI who had total or subtotal occlusion in the infarct-related left anterior desending artery in coronary angiography were enrolled the study. 18 of patients who had total occlusion received only medical theraphy, 19 of patients who had total occlusion received successful PCI+ medical theraphy and 20 of patients who had subtotal occlusion received successful PCI+ medical theraphy. Left ventricular volumes and ejection fractions (EF) were measured with echocardiography. Serum TNC, NT-proBNP and CRP levels were measured at admission and a month after treatment. RESULTS: There was significant increase in LV end-diastolic volume (LVEDV) and LV end-systolic volume (LVESV) baseline to follow-up in total-PCI group. Baseline to follow-up; a borderline significant increase was observed in LVEDV in the total-medical group. No significant difference was seen in LV volumes and EF in the subtotal-PCI group. NT-proBNP, TNC and CRP levels were decreased in all groups. The decrease in NT-proBNP and CRP values were significant in the total-medical and subtotal-PCI group but in the total-PCI group they were not significant. The decrease of TNC was significant in all groups but the lowest decrease was seen in the total-PCI group. CONCLUSION: TNC, NT-proBNP and CRP reflect LV remodelling in accordance with echocardiography after MI.
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Ahmet Çelik (2012) conducted an observational in Subacute anterior myocardial infarction (n=57). Percutaneous coronary intervention (PCI) vs. Medical therapy alone was evaluated on Change in left ventricular end-diastolic volume (LVEDV) and cardiac biomarkers at 1 month. In stable patients with subacute anterior myocardial infarction, percutaneous coronary intervention for total occlusion was associated with significant left ventricular remodeling and a blunted decrease in cardiac biomarkers compared to medical therapy.
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