Aborted myocardial infarction in patients undergoing primary percutaneous coronary intervention

Małgorzata Pyda, Stefan Grajek, Weronika Oleśkowska‑Florek, Maciej Lesiak, Andrzej Siniawski, Adrian Gwizdała, Marek Grygier, Aleksander Araszkiewicz

Abstract


Introduction. The outcome of patients with ST-elevation myocardial infarction (STEMI) strongly depends on a successful reperfusion. In some patients receiving an effective treatment myocardial infarction can be aborted.
Aim. The aim of the study was to estimate the incidence, clinical outcome, prognosis and inflammatory response in patients with aborted MI.
Material and methods. 119 consecutive patients with STEMI treated with a primary percutaneous coronary intervention (pPCI) were enrolled in the study. Aborted MI was diagnosed when the maximal increase in cardiac enzymes (CK-MB) was up to twice the upper limit of normal (CK-MB ≤ 50 U/I) and at least 50% reduction of ST-segment deviation was observed within 90 min of pPCI.
Results. Aborted MI was diagnosed in 16 subjects (13.4%). Patients with the aborted MI had lower serum troponin I levels (p < 0.0001). The time to treatment was significantly shorter in the aborted MI group (101 min vs. 220 min, p < 0.00001). Patients with aborted MI had a lower corrected TIMI frame count (p < 0.05) and a lower wall motion score index (p < 0.005), less pronounced inflammatory response (lower serum levels of IL-6, p < 0.01, and MCP-1, p < 0.05), higher ejection fraction six months after MI (72% vs. 64%, p < 0.05). None of the aborted MI patients died during the 3-year follow‑up, while there were 13 deaths among patients with non‑aborted MI.
Conclusions. The abortion of myocardial infarction results in a better outcome and more favorable prognosis. An inflammatory response is less pronounced in the aborted MI.

Keywords


STEMI; primary PCI; aborted MI

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References


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