Effect of Pressure-controlled intermittent Coronary Sinus Occlusion (PiCSO) on infarct size in anterior STEMI: PiCSO in ACS study. (June 2020)

• Record Type: Journal Article
• Authors: Egred, Mohaned; Bagnall, Alan; Spyridopoulos, Ioakim; Purcell, Ian F.; Das, Rajiv; Palmer, Nick; Grech, Ever D.; Jain, Ajay; Stone, Gregg W.; Nijveldt, Robin; McAndrew, Thomas; Zaman, Azfar
• Is Part Of: IJC heart & vasculature. Volume 28(2020)
• Publication Date: 2020-06
• Subjects: ACS acute coronary syndrome -- AMI acute myocardial infarction -- BARC Bleeding Academic Research Consortium -- CI Confidence interval -- CMR Cardiac magnetic resonance -- CRT Cardiac Resynchronization Therapy -- IMR Index of microcirculatory resistance -- LAD left anterior descending artery -- LV Left ventricle -- MACE Major adverse cardiac events -- pPCI Primary percutaneous coronary intervention -- PiCSO Pressure-controlled intermittent coronary sinus occlusion -- SD Standard deviation -- STEMI ST-segment elevation myocardial infarction -- TIMI Thrombosis in myocardial infarction; Infarct size reduction -- Pressure-controlled intermittent coronary sinus occlusion (PICSO) -- ST-segment elevation myocardial infarction (STEMI); Cardiovascular system -- Diseases -- Periodicals; Cardiovascular system -- Pathophysiology -- Periodicals; 616.1005
• DOI: 10.1016/j.ijcha.2020.100526
• Languages: English
• ISSNs: 2352-9067

Abstract

Highlights: STEMI patients treated with PiCSO were propensity matched to INFUSE-AMI controls. Infarct size at day 5 was significantly lower in the PiCSO group. There were no major adverse cardiac events (MACE) related to the PiCSO. Abstract: Background: The aim of this clinical research was to investigate the effects of Pressure-controlled intermittent Coronary Sinus Occlusion (PiCSO) on infarct size at 5 days after primary percutaneous coronary intervention (pPCI) in patients with ST-segment elevation myocardial infarction (STEMI). Methods and results: This comparative study was carried out in four UK hospitals. Forty-five patients with anterior STEMI presenting within 12 h of symptom onset received pPCI plus PiCSO (initiated after reperfusion; n = 45) and were compared with a propensity score-matched control cohort from INFUSE-AMI (n = 80). Infarct size (% of LV mass, median [interquartile range]) measured by cardiac magnetic resonance (CMR) at day 5 was significantly lower in the PiCSO group (14.3% [95% CI 9.2–19.4%] vs. 21.2% [95% CI 18.0–24.4%]; p = 0.023). There were no major adverse cardiac events (MACE) related to the PiCSO intervention. Conclusions: PiCSO, as an adjunct to pPCI, was associated with a lower infarct size at 5 days after anterior STEMI in a propensity score-matched population.