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01.11.2010 | Ausgabe 4/2010

Journal of Thrombosis and Thrombolysis 4/2010

Angiographic perfusion score assessed in patients with acute myocardial infarction is correlated with cardiac magnetic resonance infarct size and N-terminal pro-brain natriuretic peptide in 6-month follow-up

Zeitschrift:
Journal of Thrombosis and Thrombolysis > Ausgabe 4/2010
Autoren:
Tomasz Rakowski, Jacek Legutko, Pawel Kleczynski, Agata Brzozowska-Czarnek, Artur Dziewierz, Zbigniew Siudak, Waldemar Mielecki, Andrzej Urbanik, Jacek S. Dubiel, Dariusz Dudek

Abstract

Angiographic Perfusion Score (APS) proposed as a simple, angiographic score linking epicardial and myocardial perfusion parameters before and after percutaneous coronary intervention (PCI) is a predictor of short-term outcome in patients with ST-segment elevation myocardial infarction (STEMI) treated with PCI. Aim of the study was to analyze the correlation between APS and both infarct size and left ventricular function in long-term follow-up. In a cohort of 68 patients with STEMI treated with PCI APS was calculated for infarct-related artery based on angiographic parameters and was defined as the sum of the Thrombolysis in Myocardial Infarction (TIMI) flow grade (0–3 points) and the TIMI myocardial perfusion grade (0–3 points) before and after PCI (range of points from 0 to 12). Full perfusion was defined as APS ≥ 10. Cardiac magnetic resonance (CMR) parameters and N-terminal pro-brain natriuretic peptide (NT pro-BNP) were assessed at 6 months. Results: Median APS was 7.5 points. APS ≥ 10 was present in 42% of patients. The significant correlation was found between APS and: CMR infarct size (r = − 0.48; P = 0.0001), CMR left ventricular (LV) ejection fraction (r = 0.5; P = 0.002), LV end-diastolic volume index (r = − 0.37; P = 0.004), LV end-systolic volume index (r = −0.41; P = 0.001), NT pro-BNP (r = − 0.5; P = 0.02). Patients with APS ≥ 10 had significantly lower infarct size, LV volumes, higher EF and lower NT pro-BNP. APS assessed in patients with STEMI treated with PCI is a good predictor of infarct size and left ventricular function in 6-month follow-up.

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