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Murai K, Asaumi Y, Ikee T, Noguchi T. IVUS-guided stepwise thrombectomy across stenting: a potential PCI strategy for lesions with high thrombus burden. Cardiovasc Interv Ther 2023; 38:124-126. [PMID: 35761022 DOI: 10.1007/s12928-022-00872-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 06/06/2022] [Indexed: 01/26/2023]
Affiliation(s)
- Kota Murai
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1, Kishibe-shimmachi, Suita, Osaka, 564-8565, Japan. .,Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
| | - Yasuhide Asaumi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1, Kishibe-shimmachi, Suita, Osaka, 564-8565, Japan
| | - Takashi Ikee
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1, Kishibe-shimmachi, Suita, Osaka, 564-8565, Japan
| | - Teruo Noguchi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1, Kishibe-shimmachi, Suita, Osaka, 564-8565, Japan.,Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
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Pereira H, Caldeira D, Teles RC, Costa M, da Silva PC, da Gama Ribeiro V, Brandão V, Martins D, Matias F, Pereira-Machado F, Baptista J, Abreu PFE, Santos R, Drummond A, de Carvalho HC, Calisto J, Silva JC, Pipa JL, Marques J, Sousa P, Fernandes R, Ferreira RC, Ramos S, Oliveira EI, de Sousa Almeida M. Thrombus aspiration in patients with ST-elevation myocardial infarction: results of a national registry of interventional cardiology. BMC Cardiovasc Disord 2018; 18:69. [PMID: 29699478 PMCID: PMC5921398 DOI: 10.1186/s12872-018-0794-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 03/20/2018] [Indexed: 11/10/2022] Open
Abstract
Background We aimed to evaluate the impact of thrombus aspiration (TA) during primary percutaneous coronary intervention (P-PCI) in ‘real-world’ settings. Methods We performed a retrospective study, using data from the National Registry of Interventional Cardiology (RNCI 2006–2012, Portugal) with ST-elevation myocardial infarction (STEMI) patients treated with P-PCI. The primary outcome, in-hospital mortality, was analysed through adjusted odds ratio (aOR) and 95% confidence intervals (95%CI). Results We assessed data for 9458 STEMI patients that undergone P-PCI (35% treated with TA). The risk of in-hospital mortality with TA (aOR 0.93, 95%CI:0.54–1.60) was not significantly decreased. After matching patients through the propensity score, TA reduced significantly the risk of in-hospital mortality (OR 0.58, 95%CI:0.35–0.98; 3500 patients). Conclusions The whole cohort data does not support the routine use of TA in P-PCI, but the results of the propensity-score matched cohort suggests that the use of selective TA may improve the short-term risks of STEMI.
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Affiliation(s)
- Hélder Pereira
- Serviço de Cardiologia, Hospital Garcia de Orta EPE, Avenida Prof. Torrado da Silva, 2801-951, Almada, Portugal. .,Centro Cardiovascular da Universidade de Lisboa (CCUL), CAML, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal.
| | - Daniel Caldeira
- Serviço de Cardiologia, Hospital Garcia de Orta EPE, Avenida Prof. Torrado da Silva, 2801-951, Almada, Portugal.,Centro Cardiovascular da Universidade de Lisboa (CCUL), CAML, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal.,Unidade de Farmacologia Clínica, Instituto de Medicina Molecular; Laboratório de Farmacologia Clínica e Terapêutica, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal
| | - Rui Campante Teles
- Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, EPE, Lisboa, Portugal.,Registo Nacional de Cardiologia de Intervenção, APIC-CNCDC, Lisboa, Portugal
| | - Marco Costa
- Centro Hospitalar e Universitário de Coimbra - CHC, Coimbra, Portugal
| | - Pedro Canas da Silva
- Hospital de Santa Maria, Centro Hospitalar de Lisboa Norte EPE, Lisboa, Portugal
| | - Vasco da Gama Ribeiro
- Centro Hospitalar de Vila Nova de Gaia/Espinho - Hospital Eduardo Santos Silva, Porto, Portugal
| | | | - Dinis Martins
- Hospital do Divino Espírito Santo de Ponta Delgada EPE, Açores, Portugal
| | | | | | - José Baptista
- Unidade de Intervenção Cardiovascular - Alvor, Portimão, Portugal
| | | | - Ricardo Santos
- Hospital de São Bernardo, Centro Hospitalar de Setúbal EPE, Setúbal, Portugal
| | | | | | - João Calisto
- Centro Hospitalar e Universitário de Coimbra - HUC, Coimbra, Portugal
| | | | | | | | - Paulino Sousa
- Hospital de Vila Real, Centro Hospitalar de Trás-os-Montes e Alto Douro EPE, Vila Real, Portugal
| | | | - Rui Cruz Ferreira
- Hospital de Santa Marta, Centro Hospitalar Lisboa Central EPE, Lisboa, Portugal
| | - Sousa Ramos
- Hospital CUF Infante Santo, Lisboa, Portugal
| | - Eduardo Infante Oliveira
- Registo Nacional de Cardiologia de Intervenção, APIC-CNCDC, Lisboa, Portugal.,Hospital de Santa Maria, Centro Hospitalar de Lisboa Norte EPE, Lisboa, Portugal
| | - Manuel de Sousa Almeida
- Hospital de Santa Cruz. CHLO; Departamento de Fisiopatologia Nova Medical School, Lisboa, Portugal
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Abstract
To observe the effect of simvastatin in patients with acute myocardial infarction in rabbits against myocardial apoptosis, and to explore its possible mechanism. Male New Zealand white rabbits were randomized into three groups, including the myocardial infarction group (12 rabbits), the simvastatin treatment group (15 rabbits), and the sham group (12 rabbits). In the simvastatin treatment and myocardial infarction groups, the rabbits received myocardial infarction surgeries. While in the sham group, loose knots were tied in the left anterior descending coronary artery branches. The simvastatin treatment group was given simvastatin by oral gavage 24 h after surgery. Parameters, which included left ventricular end-diastolic diameter, left ventricular end-systolic diameter, left ventricular ejection fraction, and left ventricular mass index, were recorded in these three groups. Edge myocardial infarction and myocardial cell apoptosis were analyzed using TUNEL assay, and Bcl-2, Bax, and Caspase-3 protein levels were detected by Western blot. Acute myocardial infarction model was successfully established in rabbits by ligation of the left anterior descending coronary artery. Compared with the myocardial infarction group, left ventricular end-diastolic diameter (LVEDD) and left ventricular end systolic diameter (LVESD) were significantly reduced and left ventricular ejection fraction (LVEF) increased in the simvastatin treatment group. Compared with the sham group, LVEDD and LVESD were significantly increased and LVEF decreased in the simvastatin treatment group. All the differences were statistically significant (P < 0.05). Left ventricular mass index in the simvastatin treatment group was statistically lower than the myocardial infarction group. Compared with the sham group, left ventricular mass index in both the simvastatin treatment and myocardial infarction groups was significantly increased. The differences of the above comparisons were statistically significant (P < 0.05). Compared with the sham group, the apoptosis rate of the myocardial infarction group and the simvastatin treatment groups was significantly increased as shown by TUNEL assay, however, the apoptosis rate of the simvastatin treatment group was significantly lower than that of the myocardial infarction group. All the differences among above comparisons were statistically significant (P < 0.05). Bcl-2 levels significantly increased in the simvastatin treatment group compared with the myocardial infarction group, but Bcl-2 levels in both groups were significantly lower than the sham group. However, Bax protein levels showed inverse expression with Bcl-2. Meanwhile, Caspase-3 protein expression showed similar trend with Bcl-2. Simvastatin can improve cardiac function after myocardial infarction and reduce apoptosis of myocardial cells, possibly by decreasing Bax and Caspase-3 expression and increasing the expression level of Bcl-2.
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Hashimoto S, Shiraishi J, Nakamura T, Nishikawa M, Yanagiuchi T, Ito D, Kimura M, Kishita E, Nakagawa Y, Hyogo M, Shima T, Sawada T, Matoba S, Yamada H, Matsumuro A, Shirayama T, Kitamura M, Kohno Y, Furukawa K. Survivors of acute myocardial infarction at left main trunk undergoing primary percutaneous coronary intervention. Cardiovasc Interv Ther 2015; 31:89-95. [DOI: 10.1007/s12928-015-0352-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Accepted: 08/20/2015] [Indexed: 11/29/2022]
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