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. 2023 Jan 5;12(2):433.
doi: 10.3390/jcm12020433.

A Novel Reperfusion Strategy for Primary Percutaneous Coronary Intervention in Patients with Acute ST-Segment Elevation Myocardial Infarction: A Prospective Case Series

Ji-Fang He  1 , Yi-Xing Yang  1 , Jiang-Yuan Li  1 , Lu Liang  2 , Li Xu  1 , Yu Liu  1 , Zong-Sheng Guo  1 , Qi Yang  2 , Tao Jiang  2 , Xiang-Min Lin  1 , Xin-Chun Yang  1 , Mu-Lei Chen  1 , Pi-Xiong Su  1 , Jiu-Chang Zhong  1 , Le-Feng Wang  1
Affiliations

A Novel Reperfusion Strategy for Primary Percutaneous Coronary Intervention in Patients with Acute ST-Segment Elevation Myocardial Infarction: A Prospective Case Series

Ji-Fang He et al. J Clin Med. .

Abstract

Background: Ischemia reperfusion injury (IRI) remains a major problem in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). We have developed a novel reperfusion strategy for PCI and named it "volume-controlled reperfusion (VCR)". The aim of the current study was to assess the safety and feasibility of VCR in patients with STEMI.

Methods: Consecutive patients admitted to Beijing Chaoyang Hospital with STEMI were prospectively enrolled. The feasibility endpoint was procedural success. The safety endpoints included death from all causes, major vascular complications, and major adverse cardiac event (MACE), i.e., a composite of cardiac death, myocardial reinfarction, target vessel revascularization (TVR), and heart failure.

Results: A total of 30 patients were finally included. Procedural success was achieved in 28 (93.3%) patients. No patients died during the study and no major vascular complications or MACE occurred during hospitalization. With the exception of one patient (3.3%) who underwent TVR three months after discharge, no patient encountered death (0.0%), major vascular complications (0.0%), or and other MACEs (0.0%) during the median follow-up of 16 months.

Conclusion: The findings of the pilot study suggest that VCR has favorable feasibility and safety in patients with STEMI. Further larger randomized trials are required to evaluate the effectiveness of VCR in STEMI patients.

Keywords: ST-segment elevation myocardial infarction; ischemia–reperfusion injury; microvascular obstruction; percutaneous coronary intervention.

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Conflict of interest statement

The authors declare that there is no conflict of interest.

Figures

Figure 1
Figure 1
Illustration of volume-controlled reperfusion (VCR) system (a) schematic view of VCR system; (b) screenshot of VCR system; (c) VCR procedure in practice. A: guiding catheter 1; B: guiding catheter 2; C: angioplasty balloon; D: aspiration catheter; E: guide wire 1; F: guide wire 2.
Figure 2
Figure 2
Flow chart of patient selection. STEMI: ST-segment elevation myocardial infarction; TIMI: Thrombolysis in Myocardial Infarction.
See this image and copyright information in PMC

References

    1. Neumann F.J., Sousa-Uva M., Ahlsson A., Alfonso F., Banning A.P., Benedetto U., Byrne R.A., Collet J.P., Falk V., Head S.J., et al. 2018 ESC/EACTS Guidelines on myocardial revascularization. Eur. Heart J. 2019;40:87–165. doi: 10.1093/eurheartj/ehy394. - DOI - PubMed
    1. Yellon D.M., Hausenloy D.J. Myocardial reperfusion injury. N. Engl. J. Med. 2007;357:1121–1135. doi: 10.1056/NEJMra071667. - DOI - PubMed
    1. Zhao Z.Q., Corvera J.S., Halkos M.E., Kerendi F., Wang N.P., Guyton R.A., Vinten-Johansen J. Inhibition of myocardial injury by ischemic postconditioning during reperfusion: Comparison with ischemic preconditioning. Am. J. Physiol. Heart Circ. Physiol. 2003;285:H579–H588. doi: 10.1152/ajpheart.01064.2002. - DOI - PubMed
    1. Mykytenko J., Reeves J.G., Kin H., Wang N.P., Zatta A.J., Jiang R., Guyton R.A., Vinten-Johansen J., Zhao Z.Q. Persistent beneficial effect of postconditioning against infarct size: Role of mitochondrial K(ATP) channels during reperfusion. Basic Res. Cardiol. 2008;103:472–484. doi: 10.1007/s00395-008-0731-2. - DOI - PubMed
    1. Sun H., Guo T., Liu L., Yu Z., Xu W., Chen W., Shen L., Wang J., Dou X. Ischemic postconditioning inhibits apoptosis after acute myocardial infarction in pigs. Heart Surg. Forum. 2010;13:E305–E310. doi: 10.1532/HSF98.20101013. - DOI - PubMed

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