This website is intended for healthcare professionals only

Trending Topic

16 mins

Trending Topic

Developed by Touch
Mark CompleteCompleted
BookmarkBookmarked

Hypertension is the leading modifiable risk factor for global cardiovascular disease, responsible for an estimated 10.8 million deaths and more than 200 million disability-adjusted life years annually.1 Despite the availability of effective pharmacological and lifestyle interventions, prevalence continues to rise, particularly in low- and middle-income countries (LMICs), where over three-quarters of all cases now occur.2 The condition’s […]

Microvascular obstruction after successful fibrinolytic therapy in acute myocardial infarction. Comparison of reteplase vs reteplase+abciximab: A cardiovascular magnetic resonance study

Antonello Zoni, Peter Knoll, Tiziano Gherli
< 1 min
Share
Facebook
X (formerly Twitter)
LinkedIn
Via Email
Mark CompleteCompleted
BookmarkBookmarked
Copy LinkLink Copied
Download as PDF
Published Online: Jul 25th 2018 Heart International 2006;2(1):54-65
Select a Section…
1

Abstract

Overview

Background. About one third of patients with TIMI 3 after reperfusion have evidence
of microvascular obstruction (MO) which represents an independent predictor of myocardial
wall rupture. This explains all efforts made to prevent MO. Magnetic resonance imaging
(MRI) has proved to be particularly useful in detecting MO. The aim of this study was to evaluate
with MRI if different fibrinolytic regimens in acute myocardial infarction display different effects
on left ventricle (LV) volumes and ejection fraction (EF), as well as on myocardial infarct size
(MIsz) and MO.
Methods. Twenty male patients, mean age 58 years, affected by acute myocardial infarction, ten
anterior and ten inferior, were treated with: full dose reteplase in ten, and half dose reteplase plus
full dose abciximab (R+Abcx) in the other ten patients. In the fourth day after hospital admission,
MRI STIR T2 images were used to quantify MIsz, while 2dflash cineloops were used after the injection
of gadolinium, to quantify LV volumes, EF and to detect MO.
Results. LV EF was higher in R+Abcx 51±10 than in reteplase 41±8. MIsz was similar in both
treatment groups: however a close relationship was present between MIsz and EF in the
reteplase group indicating that the greater the MIsz the lower the EF. In R+Abcx this relationship
was no longer present, suggesting a protective effect of the drug on microcirculation. In fact extensive
MO was present in 25% of all cases, 80% of which in the reteplase group while only 20%
in R+Abcx.
Conclusion. R+Abcx prevents MO: compared to traditional fibrinolytic therapy it allows better
LV function and most likely improved long term survival. (Heart International 2006; 2: 54-65)

Keywords

Magnetic resonance, Myocardial infarction, Microvascular obstruction

2

Article Information

Correspondence

Antonello Zoni, MD, Heart Department, University Hospital of Parma, Via Gramsci, 14, 43100 Parma – Italy, antonello.zoni@libero.it

3

Further Resources

Share
Facebook
X (formerly Twitter)
LinkedIn
Via Email
Mark CompleteCompleted
BookmarkBookmarked
Copy LinkLink Copied
Download as PDF
Close Popup