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Impact of collateral flow on myocardial reperfusion and infarct size in patients undergoing primary angioplasty for acute myocardial infarction.

Publication ,  Journal Article
Sorajja, P; Gersh, BJ; Mehran, R; Lansky, AJ; Krucoff, MW; Webb, J; Cox, DA; Brodie, BR; Stone, GW
Published in: Am Heart J
August 2007

BACKGROUND: The prognostic impact of baseline collateral flow of the infarct-related artery (IRA) in patients undergoing primary percutaneous coronary intervention (PCI) remains controversial. We sought to examine the impact of baseline collateral flow to the IRA on reperfusion success, infarct size, and clinical outcomes in patients undergoing primary PCI for acute myocardial infarction (AMI). METHODS AND RESULTS: Acute procedural, 30-day, and 6-month clinical outcomes were assessed after primary PCI among patients enrolled in the EMERALD trial (n = 501 with AMI within 6 hours of onset). Patients with collateral flow to the IRA (Rentrop grade 2 or 3) more commonly had prior stable angina, less commonly had failed thrombolysis and left anterior descending artery occlusion, and presented with less ST-segment elevation. Myocardial reperfusion assessed by ST-segment recovery and myocardial blush was similar in patients with and without baseline collateral flow to the IRA. Infarct size (assessed by technetium Tc 99m sestamibi) was similar among patients with and without baseline collateral flow in anterior infarction (mean 28.5% vs 31.2%, respectively; P = .59) and nonanterior infarction (12.5% vs 12.1%, respectively; P = .81). There were no differences in the rates of major adverse cardiac events at 30 days or 6 months according to baseline IRA collateral flow. CONCLUSIONS: Among patients undergoing primary PCI for AMI within 6 hours of symptom onset, we found no significant relationship between baseline collateral flow and either reperfusion success, infarct size, or subsequent clinical outcomes.

Duke Scholars

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

August 2007

Volume

154

Issue

2

Start / End Page

379 / 384

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Radionuclide Imaging
  • Prognosis
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Humans
  • Female
  • Coronary Circulation
  • Collateral Circulation
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Sorajja, P., Gersh, B. J., Mehran, R., Lansky, A. J., Krucoff, M. W., Webb, J., … Stone, G. W. (2007). Impact of collateral flow on myocardial reperfusion and infarct size in patients undergoing primary angioplasty for acute myocardial infarction. Am Heart J, 154(2), 379–384. https://doi.org/10.1016/j.ahj.2007.04.034
Sorajja, Paul, Bernard J. Gersh, Roxana Mehran, Alexandra J. Lansky, Mitchell W. Krucoff, John Webb, David A. Cox, Bruce R. Brodie, and Gregg W. Stone. “Impact of collateral flow on myocardial reperfusion and infarct size in patients undergoing primary angioplasty for acute myocardial infarction.Am Heart J 154, no. 2 (August 2007): 379–84. https://doi.org/10.1016/j.ahj.2007.04.034.
Sorajja P, Gersh BJ, Mehran R, Lansky AJ, Krucoff MW, Webb J, et al. Impact of collateral flow on myocardial reperfusion and infarct size in patients undergoing primary angioplasty for acute myocardial infarction. Am Heart J. 2007 Aug;154(2):379–84.
Sorajja, Paul, et al. “Impact of collateral flow on myocardial reperfusion and infarct size in patients undergoing primary angioplasty for acute myocardial infarction.Am Heart J, vol. 154, no. 2, Aug. 2007, pp. 379–84. Pubmed, doi:10.1016/j.ahj.2007.04.034.
Sorajja P, Gersh BJ, Mehran R, Lansky AJ, Krucoff MW, Webb J, Cox DA, Brodie BR, Stone GW. Impact of collateral flow on myocardial reperfusion and infarct size in patients undergoing primary angioplasty for acute myocardial infarction. Am Heart J. 2007 Aug;154(2):379–384.
Journal cover image

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

August 2007

Volume

154

Issue

2

Start / End Page

379 / 384

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Radionuclide Imaging
  • Prognosis
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Humans
  • Female
  • Coronary Circulation
  • Collateral Circulation