OBJECTIVES: This study sought to compare the impact of primary coronary angioplasty and thrombolytic therapy for @entity583 ( @entity583 ) on 1-month @entity1188 size and microvascular perfusion. BACKGROUND: The effect of the reperfusion strategies of primary coronary angioplasty and thrombolytic therapy on microvascular integrity still remains to be determined. METHODS: Sixty-two consecutive @entity1 with a first @entity583 , undergoing intravenous @entity3479 ( @entity3479 ) therapy (32 @entity1 , Group I) or primary angioplasty (30 @entity1 , Group II), were studied. Only @entity1 with 1-month Thrombolysis in @entity583 (TIMI) flow grade 2 or 3 were selected for the study. @entity1 in whom primary angioplasty was unsuccessful or those with clinical evidence of failed reperfusion were excluded. Microvascular perfusion was assessed at 1 month by intracoronary injection of sonicated microbubbles. Contrast score index (CSI) and wall motion score index (WMSI) were derived using qualitative methods. RESULTS: At baseline there were no significant differences between groups for age, risk factors, time to hospital presentation, Killip class on admission, prevalence of multivessel disease or anterior @entity1188 site, @entity1188 area extension before reperfusion, peak @entity908 kinase levels and postinfarction treatment. Conversely, significant differences between groups were found at follow-up for percent residual @entity1188 (70 +/- 12 vs 36 +/- 14 [mean +/- SD], p = 0.0001), CSI (1.02 +/- 0.4 vs. 1.49 +/- 0.5, p = 0.0003) and WMSI (1.67 +/- 0.3 vs. 1.45 +/- 0.3, p = 0.015). In particular, in the subset of @entity1 with TIMI grade 3 flow, a perfusion defect occurred in one or more segments subtended by the IRA in 72% of Group I versus 31% of Group II @entity1 (p < 0.00001) and in 27% of Group I versus 8% of Group II segments (p < 0.00001). CONCLUSIONS: The present study shows, in a highly selected cohort with successful IRA recanalization, that primary angioplasty is more effective than thrombolysis in preserving microvascular flow and preventing extension of @entity296 at 1-month after @entity583 .

XXXX therapy versus primary coronary angioplasty: impact on myocardial tissue perfusion and regional function 1 month after uncomplicated @entity583 .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity296 :: ('MESH:D009202', 'Disease') :: ['myocardial damage'] @entity908 :: ('MESH:D003401', 'Chemical') :: ['creatine'] @entity1188 :: ('MESH:D007238', 'Disease') :: ['infarct related-artery (IRA) stenosis', 'infarct'] @entity583 :: ('MESH:D009203', 'Disease') :: ['AMI', 'Myocardial Infarction', 'acute myocardial infarction'] @entity3479 :: ('5327', 'Gene') :: ['tissue-type plasminogen activator', 't-PA']
@entity3479 :: (5327,Gene) :: ['Tissue-type plasminogen activator']
