Abstract
Impact of Low-Dose Intracoronary Alteplase Infusion after Successful Primary Percutaneous Coronary Intervention
Highlights
The corner stone in ST elevation myocardial infarction (STEMI) management is timely and successful recanalization of infarct related artery (IRA) using primary percutaneous coronary intervention (PPCI) [1]
global longitudinal strain (GLS) and left ventricular (LV) synchrony were better in alteplase group both at 48 hours (p value 0.02 and < 0.001 respectively) and at 6 months (p value < 0.001 for each)
The main findings in our study are that intracoronary alteplase after PPCI resulted in: 1. Significant improvement in epicardial and myocardial coronary flow without significant difference in TIMI major bleeding
Summary
102 anterior STEMI patients eligible for PPCI were divided into: Alteplase group (53 patients; received intracoronary 0.3 mg/kg alteplase after PPCI) and control group (49 patients; treated with PPCI only). LV longitudinal function was assessed using tissue Doppler imaging (to measure mean S' and maximum Q-S' time difference) and speckle tracking (to measure global longitudinal strain (GLS)) 48 hours and 6 months after PPCI. Epicardial (p value < 0.001 for corrected TIMI frame count) and myocardial perfusion (p value for myocardial blush grade 0.03) were significantly higher. GLS and LV synchrony were better in alteplase group both at 48 hours (p value 0.02 and < 0.001 respectively) and at 6 months (p value < 0.001 for each). No difference in bleeding rates was noted between groups
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