Feasibility and applicability of computer-assisted myocardial blush quantification after primary percutaneous coronary intervention for ST-segment elevation myocardial infarction.
OBJECTIVE
The aim of the study was to evaluate whether the "Quantitative Blush Evaluator" (QuBE) score is associated with measures of myocardial reperfusion in patients with ST-segment elevation myocardial infarction (STEMI) treated in two hospitals with 24/7 coronary intervention facilities.


BACKGROUND
QuBE is an open source computer program to quantify myocardial perfusion. Although QuBE has shown to be practical and feasible in the patients enrolled in the Thrombus Aspiration during Percutaneous Coronary Intervention in Acute Myocardial Infarction Study (TAPAS), QuBE has not yet been verified on reperfusion outcomes of primary percutaneous coronary intervention (PCI) patients treated in other catheterization laboratories.


METHODS
Core lab adjudicated angiographic outcomes and QuBE values were assessed on angiograms of patients who were enrolled in the PRoximal Embolic Protection in Acute myocardial infarction and Resolution of ST-Elevation (PREPARE) trial. ST-segment resolution immediately after PCI measured by continuous ST Holter monitoring was calculated by a blinded core lab.


RESULTS
The QuBE score could be assessed on 229 of the 284 angiograms (81%) and was significantly associated with visually assessed myocardial blush grade (P < 0.0001). Patients with improved postprocedural Thrombolysis in Myocardial Infarction-graded flow, myocardial blush grade, ST-segment resolution immediately after PCI, or a small infarct size measured by peak CK-MB had a significant better QuBE score.


CONCLUSIONS
QuBE is feasible and applicable at angiograms of patients with STEMI recorded at other catheterization laboratories and is associated with measures of myocardial reperfusion.
Haeck
Joost D E
JD
Department of Cardiology, Academic Medical Center, University of Amsterdam, The Netherlands. J.D.Haeck@amc.uva.nl
Gu
Youlan L
YL
Vogelzang
Mathijs
M
Bilodeau
Luc
L
Krucoff
Mitchell W
MW
Tijssen
Jan G P
JG
De Winter
Robbert J
RJ
Zijlstra
Felix
F
Koch
Karel T
KT
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography / Q000379:methods*; D003326:Coronary Circulation; D015716:Electrocardiography, Ambulatory; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy*; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D009426:Netherlands; D009657:North Carolina; D011237:Predictive Value of Tests; D011792:Quebec; D011857:Radiographic Image Interpretation, Computer-Assisted; D016032:Randomized Controlled Trials as Topic; D012984:Software; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome