Key result
Primary PCI shows no RV function benefit over thrombolytic therapy at 72 hours post-STEMI.
Why the study?
Right ventricular function after successful reperfusion in STEMI and differences between reperfusion strategies were not well characterized.
Observational (n=81)
Absolute Event Rate: 0.39% vs 0.39%
RV dysfunction occurs in anterior but not non-anterior STEMI irrespective of reperfusion modality; leaves open whether routine RV assessment improves outcomes in successfully reperfused patients.
PURPOSE: To investigate right ventricle function in successfully reperfused ST elevated myocardial infarction (STEMI) and to compare reperfusion strategies. METHODS: From January 2007 to August 2008, 33 patients with anterior myocardial infarction (MI) and 48 patients with non-anterior myocardial infarction were enrolled in this study. Patients were treated with thrombolytic therapy (TT) or primary percutanaeous coronary intervention (PPCI) (Primary intervention: 16 and 25 patients (anterior and non-anterior consecutively), thrombolytic therapy: 17 and 23 patients (anterior and non-anterior consecutively)). Right ventricle (RV) function was analyzed using tissue Doppler investigation (TDI) after 72 hr of successful reperfusion. RESULTS: There was no difference in right ventricle function assessed by right ventricle TDI Tei index between the PPCI and TT group (0.39+/-0.20 vs. 0.39+/-0,17). RV TDI Tei index increased in anterior MI patients treated with either PPCI or TT compared with control group (0.39+/-0.11 vs. 0.27+/-0.16, P=0.015 and 0.43+/-0.18 vs. 0.27+/-0.16 , P= 0.014 respectively). RV TDI Tei index did not differ between non-anterior MI patients treated with either PPCI or TT and control group (0.38+/-0.23 vs. 0.27+/-0.16, and 0.37+/-0.16 vs. 0.27+/-0.16, respectively). CONCLUSIONS: RV function deteriorated in STEMI compared with healthy controls. Contrary to the expectation, RV dysfunction was observed in anterior STEMI, but not in non anterior MI. There was no difference in RV function between the two treatment modalities.
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Karakurt et al. (2009) conducted an observational in ST elevation myocardial infarction (n=81). Primary percutaneous coronary intervention (PPCI) vs. Thrombolytic therapy (TT) was evaluated on Right ventricle function assessed by right ventricle TDI Tei index. Primary percutaneous coronary intervention and thrombolytic therapy resulted in similar right ventricular function (TDI Tei index 0.39 vs 0.39) at 72 hours in patients with reperfused STEMI.
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