Distal Protection During Primary Coronary Intervention Can Preserve the Index of Microcirculatory Resistance in Patients With Acute Anterior ST-Segment Elevation Myocardial Infarction

Noritoshi Ito; Shinsuke Nanto; Yasuji Doi; Yuma Kurozumi; Daisuke Tonomura; Tomoaki Natsukawa; Hirotaka Sawano; Daisaku Masuda; Shizuya Yamashita; Ken-ichiro Okada; Yasuyuki Hayashi; Tatsuro Kai; Toru Hayashi

doi:10.1253/circj.CJ-10-0133

Cardiovascular Intervention

Distal Protection During Primary Coronary Intervention Can Preserve the Index of Microcirculatory Resistance in Patients With Acute Anterior ST-Segment Elevation Myocardial Infarction

Noritoshi Ito, Shinsuke Nanto, Yasuji Doi, Yuma Kurozumi, Daisuke Tonomura, Tomoaki Natsukawa, Hirotaka Sawano, Daisaku Masuda, Shizuya Yamashita, Ken-ichiro Okada, Yasuyuki Hayashi, Tatsuro Kai, Toru Hayashi

Author information

Noritoshi Ito
Senri Critical Care Medical Center, Critical & Cardiovascular Care Unit, Osaka Saiseikai Senri Hospital
Shinsuke Nanto
Department of Advanced Cardiovascular Therapeutics, Osaka University Graduate School of Medicine
Yasuji Doi
Division of Cardiovascular Medicine, Critical & Cardiovascular Care Unit, Osaka Saiseikai Senri Hospital
Yuma Kurozumi
Senri Critical Care Medical Center, Critical & Cardiovascular Care Unit, Osaka Saiseikai Senri Hospital
Daisuke Tonomura
Senri Critical Care Medical Center, Critical & Cardiovascular Care Unit, Osaka Saiseikai Senri Hospital
Tomoaki Natsukawa
Senri Critical Care Medical Center, Critical & Cardiovascular Care Unit, Osaka Saiseikai Senri Hospital
Hirotaka Sawano
Senri Critical Care Medical Center, Critical & Cardiovascular Care Unit, Osaka Saiseikai Senri Hospital
Daisaku Masuda
Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
Shizuya Yamashita
Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
Ken-ichiro Okada
Division of Cardiovascular Medicine, Critical & Cardiovascular Care Unit, Osaka Saiseikai Senri Hospital
Yasuyuki Hayashi
Senri Critical Care Medical Center, Osaka Saiseikai Senri Hospital
Tatsuro Kai
Senri Critical Care Medical Center, Osaka Saiseikai Senri Hospital
Toru Hayashi
Division of Cardiovascular Medicine, Critical & Cardiovascular Care Unit, Osaka Saiseikai Senri Hospital

Keywords: Acute m yocardial infarction, Distal protection, Index of microcirculatory resistance, Microcirculation

JOURNAL FREE ACCESS

2011 Volume 75 Issue 1 Pages 94-98

DOI https://doi.org/10.1253/circj.CJ-10-0133

View "Advance Publication" version (November 23, 2010).

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Abstract

Background: The objective of this study was to investigate whether a distal protection (DP) device can preserve the index of microcirculatory resistance (IMR) after primary percutaneous coronary intervention (PCI) in patients with anterior ST-segment elevation myocardial infarction (STEMI). Methods and Results: The study group of 36 consecutive patients with anterior STEMI were randomized into 2 groups of primary PCI with or without DP: stenting without DP (non-DP group, n=17) and with DP (DP group, n=19). The DP in all cases was Filtrap (Nipro, Japan). Following final coronary angiography after successful PCI, IMR was measured using PressureWire^TM Certus (St Jude Medical, USA) at maximal hyperemia. The averaged IMR of the 36 patients with STEMI after primary PCI was 31.6U. The IMR in the DP group was significantly lower than that in the non-DP group (26.6±25.8U vs. 37.2±23.2U, P=0.03242). Conclusions: DP as an adjunctive therapy of PCI for acute anterior STEMI may have beneficial effects on myocardial microcirculation because of preservation of IMR. (Circ J 2011; 75: 94-98)

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