V Rekha, Rao Sudhakar, Nayak Krishnananda, M Manjoosha, Samanth Jyothi, R Padmakumar
Department of Cardiovascular Technology, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India.
Department of Cardiology, Manipal Hospitals,Bengaluru, India.
Future Cardiol. 2025 Mar;21(4):237-243. doi: 10.1080/14796678.2025.2472581. Epub 2025 Mar 4.
Effective myocardial reperfusion in ST-Elevation Myocardial Infarction (STEMI) remains challenging despite advancements in primary percutaneous coronary intervention (PCI). This study evaluates the impact of thrombus aspiration (TA) and saline autotransfusion (SAT) compared to standard PCI (NOTA) on coronary flow dynamics and myocardial perfusion.
This prospective cohort study enrolled 157 STEMI patients who underwent primary PCI. Participants were divided into two groups: TA+SAT ( = 80) and NOTA ( = 77). Clinical parameters such as blood pressure, ejection fraction, ST-segment resolution, thrombolysis in myocardial infarction (TIMI) flow grades, corrected TIMI frame count (CTFC), and myocardial infarction (MI) location were assessed.
Patients in the TA+SAT group exhibited significantly better short-term myocardial reperfusion, as indicated by superior ST-segment resolution ( = 0.010) and lower CTFC values ( < 0.001). Blood pressure was significantly lower in the TA+SAT group ( = 0.042). However, ejection fraction improvement at one month was not statistically significant. TIMI and TMPG flow grades were comparable between groups.
The TA+SAT approach demonstrated improved coronary flow dynamics and better short-term myocardial reperfusion in STEMI patients without additional pharmacological interventions. These findings suggest that TA+SAT may serve as a valuable adjunct to PCI, warranting further investigation into its long-term clinical benefits.
尽管在直接经皮冠状动脉介入治疗(PCI)方面取得了进展,但ST段抬高型心肌梗死(STEMI)的有效心肌再灌注仍然具有挑战性。本研究评估了血栓抽吸(TA)和盐水自体输血(SAT)与标准PCI(NOTA)相比对冠状动脉血流动力学和心肌灌注的影响。
这项前瞻性队列研究纳入了157例接受直接PCI的STEMI患者。参与者被分为两组:TA+SAT组(n = 80)和NOTA组(n = 77)。评估了诸如血压、射血分数、ST段分辨率、心肌梗死溶栓(TIMI)血流分级、校正TIMI帧计数(CTFC)和心肌梗死(MI)部位等临床参数。
TA+SAT组患者表现出明显更好的短期心肌再灌注,表现为更高的ST段分辨率(P = 0.010)和更低的CTFC值(P < 0.001)。TA+SAT组的血压明显更低(P = 0.042)。然而,1个月时射血分数的改善没有统计学意义。两组之间的TIMI和TMPG血流分级相当。
TA+SAT方法在STEMI患者中显示出改善的冠状动脉血流动力学和更好的短期心肌再灌注,且无需额外的药物干预。这些发现表明,TA+SAT可能是PCI的一种有价值的辅助手段,值得进一步研究其长期临床益处。