Page 78 - Coronary hemodynamics in acute myocardial infarction - Matthijs Bax

Chapter 5
We hypothesize that microvascular function, as assessed by means of Doppler flow velocity measurement, plays an important role in long-term clinical outcome after primary PCI for STEMI. Therefore, we sought to determine the prognostic value for long-term cardiac mortality of microvascular function, as assessed by Doppler flow velocity measurement, in infarct-related as well as reference coronary arteries after primary PCI for STEMI.
Methods
Data Source and Patient Selection
Between April 1997 and August 2000, 100 consecutive patients with a first anterior wall STEMI treated by primary PCI were enrolled in the study, for whom the initial results have been reported previously.8,20 All patients were treated in the Academic Medical Center in Amsterdam, a large tertiary referral center in Amsterdam, The Netherlands.
Anterior STEMI was defined as chest pain lasting >30 minutes in the presence of persistent ST-segment elevation in ≥2 precordial leads. Primary PCI was performed within 6 hours after the onset of symptoms according to standard clinical practice, with provisional bare metal stent implantation. Major exclusion criteria comprised prior anterior wall myocardial infarction (MI), acute left-side heart failure (Killip class >II), prior coronary artery bypass grafting, known left ventricular ejection fraction of <40%, left ventricular hypertrophy, absence of thoracic windows for echocardiography, 3-vessel coronary artery
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