Journal of cardiovascular medicine (Hagerstown, Md.) · 2014
Blunted inflammatory response in STEMI patients timely reperfused.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Brunetti Natale Daniele, Correale Michele, De Gennaro Luisa, Cuculo Andrea, Pellegrino Pier Luigi, Di Biase Matteo
Аннотация
BACKGROUND: Acute coronary syndrome is characterized by an acute inflammatory systemic response. We investigated whether timely reperfusion could reduce the inflammatory response in patients with ST-elevation acute myocardial infarction (STEMI).
METHODS: Forty-seven consecutive patients with STEMI eligible for fibrinolysis and admitted to a coronary care unit were enrolled in the study and reperfused with tenecteplase; 33 patients admitted 6 h after the onset of chest pain (late comers), who therefore underwent delayed coronary angioplasty, acted as controls. All patients underwent serial blood sampling in order to evaluate plasma concentrations of C-reactive protein (CRP), fibrinogen and erythrocyte sedimentation rate (ESR) for 4 days. Patients treated with primary (<6 h from symptom onset) or rescue angioplasty were excluded from the study.
RESULTS: CRP, ESR and fibrinogen in patients who were timely reperfused showed significantly lower values compared to late comer controls (P < 0.05). In a multivariable analysis considering age, sex, diabetes, presence of anterior wall infarction, presence of Q-waves, left-ventricular ejection fraction and peak troponin levels, timely reperfusion was inversely related to CRP peak values (hazard ratio 0.74, 95% confidence interval 0.55-0.98, P < 0.05).
CONCLUSION: Timely reperfusion can blunt inflammatory activation in patients with STEMI.
METHODS: Forty-seven consecutive patients with STEMI eligible for fibrinolysis and admitted to a coronary care unit were enrolled in the study and reperfused with tenecteplase; 33 patients admitted 6 h after the onset of chest pain (late comers), who therefore underwent delayed coronary angioplasty, acted as controls. All patients underwent serial blood sampling in order to evaluate plasma concentrations of C-reactive protein (CRP), fibrinogen and erythrocyte sedimentation rate (ESR) for 4 days. Patients treated with primary (<6 h from symptom onset) or rescue angioplasty were excluded from the study.
RESULTS: CRP, ESR and fibrinogen in patients who were timely reperfused showed significantly lower values compared to late comer controls (P < 0.05). In a multivariable analysis considering age, sex, diabetes, presence of anterior wall infarction, presence of Q-waves, left-ventricular ejection fraction and peak troponin levels, timely reperfusion was inversely related to CRP peak values (hazard ratio 0.74, 95% confidence interval 0.55-0.98, P < 0.05).
CONCLUSION: Timely reperfusion can blunt inflammatory activation in patients with STEMI.
Предметные рубрики MeSH
AgedBiomarkersBlood SedimentationC-Reactive ProteinCoronary AngiographyFemaleFibrinogenFibrinolytic AgentsHumansInflammationInflammation MediatorsMaleMiddle AgedMultivariate AnalysisMyocardial InfarctionRisk FactorsTenecteplaseThrombolytic TherapyTime FactorsTime-to-TreatmentTissue Plasminogen ActivatorTreatment Outcome