Einthoven Dissertation Prizes
Primary PCI for acute myocardial infarction: clinical and anglographic features PCI vs. streptokinase in STEMI The so-called 'Zwolle study' was performed with the financial support of the Netherlands Heart Foundation. In this study, 395 patients with an acute ST-segment elevation myocardial infarction (STEMI) were randomised to either primary percutaneous coronary intervention (PCI) or to treatment with streptokinase (SK). After follow-up of eight years, 105 patients had died, 42 patients in the PCI group and 63 patients in the SK group (p=0.03). The combined incidence of death and recurrent nonfatal infarction occurred in 53 patients ofthe PCI group compared with 94 patients of the SK group (p1. Patients with VF during PCI (n=74, 3%) had an inferior STEMI location.
STEMI, PCI, distal embolisation and myocardial perfusion The aim of reperfusion therapy is not merely to achieve TIMI 3 flow in the epicardial vessel but to reperfuse the myocardium at risk at the tissue level. Distal embolisation is thought to be involved in suboptimal reperfusion of the myocardium at risk. Distal embolisation was visualised on the angiogram after primary PCI in 15% of the patients. It was associated with reduced myocardial reperfusion, larger infarct size and poor clinical outcome. Even when PCI was successful and TIMI 3 flow was achieved in the epicardial vessel, angiographic evidence of distal embolisation was an independent predictor of infarct size. Intracoronary stenting was not associated with more distal embolisation during primary PCI. Angiographic evidence of distal embolisation before PCI was visualised in 5% (lower limit) of the patients. It was associated with angiographic evidence of thrombus, less successful PCI (TIMI
Primary PCI for acute myocardial infarction: clinical and anglographic features PCI vs. streptokinase in STEMI The so-called 'Zwolle study' was performed with the financial support of the Netherlands Heart Foundation. In this study, 395 patients with an acute ST-segment elevation myocardial infarction (STEMI) were randomised to either primary percutaneous coronary intervention (PCI) or to treatment with streptokinase (SK). After follow-up of eight years, 105 patients had died, 42 patients in the PCI group and 63 patients in the SK group (p=0.03). The combined incidence of death and recurrent nonfatal infarction occurred in 53 patients ofthe PCI group compared with 94 patients of the SK group (p1. Patients with VF during PCI (n=74, 3%) had an inferior STEMI location.
STEMI, PCI, distal embolisation and myocardial perfusion The aim of reperfusion therapy is not merely to achieve TIMI 3 flow in the epicardial vessel but to reperfuse the myocardium at risk at the tissue level. Distal embolisation is thought to be involved in suboptimal reperfusion of the myocardium at risk. Distal embolisation was visualised on the angiogram after primary PCI in 15% of the patients. It was associated with reduced myocardial reperfusion, larger infarct size and poor clinical outcome. Even when PCI was successful and TIMI 3 flow was achieved in the epicardial vessel, angiographic evidence of distal embolisation was an independent predictor of infarct size. Intracoronary stenting was not associated with more distal embolisation during primary PCI. Angiographic evidence of distal embolisation before PCI was visualised in 5% (lower limit) of the patients. It was associated with angiographic evidence of thrombus, less successful PCI (TIMI
