Abortion of myocardial infarction by primary angioplasty mainly depends on preprocedural TIMI flow.
OBJECTIVE
To define frequency and predictors of aborted myocardial infarctions (MI) after primary angioplasty.


RESULTS
We analysed 196 consecutive patients with the clinical diagnosis of ST-elevation acute coronary syndrome (ST-ACS) admitted for primary angioplasty to one interventional facility between October 2005 and September 2006. Aborted MI was defined as a creatine increase of less than two times the upper limit of normal, combined with typical evolutionary electrocardiographic changes. Masquerading MI was diagnosed if evolutionary changes were missing or could be attributed to other causes. Thirty-four patients (17,3%) had an aborted and nine (4,6%) a masquerading MI. The main predictor of abortion was Thrombolysis In Myocardial Infarction (TIMI) flow 2 or 3 prior to procedure. The in-hospital mortality of aborted MI was 0%, the one year mortality 2.9%. Sixteen patients without prior or inter-current myocardial infarction had a preserved ejection fraction on cardiac MR at 12 months; in six patients even without any detection of late enhancement.


CONCLUSIONS
There is a substantial proportion of aborted myocardial infarction after primary angioplasty, corresponding to a small or even non detectable scar formation in terms of late enhancement on cardiac MR. Preprocedural TIMI flow 2 or 3 is the main predictor of aborted MI.
Department of Cardiology, Schwarzwald-Baar-Klinikum, Villingen-Schwenningen, Germany. ralf.birkemeyer@sbk-vs.de
Ralf
R
Birkemeyer
Andreas
A
Rillig
Fabian
F
Treusch
Annette
A
Koch
Tomislav
T
Miljak
Udo
U
Meyerfeldt
Markus
M
Kunze
Werner
W
Jung
Martin
M
Höher
D054058:Acute Coronary Syndrome / Q000503:physiopathology / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary; D015415:Biomarkers / Q000097:blood; D003326:Coronary Circulation; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000517:prevention & control*; D011379:Prognosis
D015415:Biomarkers