Gradual Versus Abrupt Reperfusion During Primary Percutaneous Coronary Interventions in ST-Segment-Elevation Myocardial Infarction (GUARD)


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Sezer M. , Escaned J., Broyd C. J. , Umman B. , Bugra Z. , Ozcan I., ...More

JOURNAL OF THE AMERICAN HEART ASSOCIATION, vol.11, no.10, 2022 (Journal Indexed in SCI) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 11 Issue: 10
  • Publication Date: 2022
  • Doi Number: 10.1161/jaha.121.024172
  • Journal Name: JOURNAL OF THE AMERICAN HEART ASSOCIATION
  • Journal Indexes: Science Citation Index Expanded, Scopus, CAB Abstracts, CINAHL, EMBASE, MEDLINE, Veterinary Science Database, Directory of Open Access Journals
  • Keywords: coronary microvascular resistance, intramyocardial hemorrhage, microvascular injury, myocardial edema, primary PCI, reperfusion injury, ST-segment-elevation myocardial infarction, ZERO-FLOW PRESSURE, MICROVASCULAR OBSTRUCTION, PROGNOSTIC VALUE, NO-REFLOW, SIZE, HEMODYNAMICS, RESTORATION, DYSFUNCTION, IMPROVEMENT, HEMORRHAGE

Abstract

BACKGROUND: Intramyocardial edema and hemorrhage are key pathological mechanisms in the development of reperfusion-related microvascular damage in ST-segment-elevation myocardial infarction. These processes may be facilitated by abrupt restoration of intracoronary pressure and flow triggered by primary percutaneous coronary intervention. We investigated whether pressure-controlled reperfusion via gradual reopening of the infarct-related artery may limit microvascular injury in patients undergoing primary percutaneous coronary intervention.