Myocardial Protection Via the Coronary Sinus : Long-Term Effects of Intermittent Coronary Sinus Occlusion as an Adjunct to Reperfusion in Acute Myocardial Infarction

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• Background Recent reports on facilitated reperfusion therapy re-address interests in coronary sinus interventions (CSI). Patients in whom short time results have been reported earlier were re-evaluated, with the aim of gathering the long-term results of pressure-controlled intermittent coronary sinus occlusion (PICSO) generated in patients with acute myocardial infarction (MI) and revascularization. Methods and Results Thirty-four patients with ST elevated MI, in whom complete revascularization was achieved, underwent primary thrombolysis with or without PICSO. Follow-up data from these patients were collected for at least 48 months. Immediate perioperative differences were observed for time to peak creatine kinase (CK), as well as cumulative CK. In addition, the time until reperfusion was considerably less than for the control group (p=0.014). Long-term data showed significant differences in reinfarction (p=0.015), as well as in major adverse cardiovascular events, between the 2 groups (p<0.0001). Conclusion These data, because of the wide interval between collection and current analysis, could have inherited historical bias. Nonetheless, they are also uniquely indicating the potential of CSI to induce not only immediate, but also clinically significant long-term, effects as an adjunct to reperfusion therapy. Therefore, CSI should be, once again, on the study agenda and be placed under contemporary and best-available scientific scrutiny..

• 社団法人日本循環器学会の論文
• 2008-03-20

著者

• HIRAYAMA Atsushi

  Osaka Police Hospital

• KOMAMURA Kazuo

  Department of Cardiovascular Dynamics, Research Institute, National Cardiovascular Center

• KODAMA Kazuhisa

  Cardiovascular Division, Osaka Police Hospital

• Komamura K

  Department Of Cardiovascular Dynamics Research Institute National Cardiovascular Center

• Hirayama A

  Division Of Cardiovascular Medicine Department Of Medicine Nihon University School Of Medicine

• Kosuge Kotoko

  日本大学 医学部内科学系腎臓高血圧内分泌内科

• Kosuge Kotoko

  Division Of Nephrology Hypertension And Endocrinology Department Of Medicine Nihon University School

• Kodama K

  Cardiovascular Division Osaka Police Hospital

• Komamura Kazuo

  オーストラリア

• Hirayama Atsushi

  Cardiovascular Division, Osaka Police Hospital

• Mohl Werner

  Department of Cardiothoracic Surgery, Medical University of Vienna

• Kasahara Hirofumi

  Department of Cardiothoracic Surgery

• Heinze Georg

  Core Unit for Medical Statistics and Informatics Section of Clinical Biometrics

• Glogar Dietmar

  Department of Cardiology, Medical University of Vienna

• Kodama Kazuhisa

  大阪大学 医学系研究科病態情報内科学

• Kodama Kazuhisa

  Department Of Animal Sciences College Of Bioresource Sciences Nihon University

• Kanmatsuse K

  Depaartment Of Cardiology Nihon University Surugadai Hospital

• Hirayama Atsushi

  Division Of Cardiology Department Of Medicine Nihon University School Of Medicine

• Hirayama Atsushi

  日本大学 医学部内科学系循環器内科

• Kanmatsuse K

  Nihon Univ. School Of Medicine

• Hanatani Akihisa

  国立循環器病研究センター 心臓血管内科部門

• Komamura Kazuo

  Department Of Cardiology National Cardiovascular Center

• Akamatsu Hiroki

  Department Of Cardiology Nihon University Surugadai Hospital

• Mohl Werner

  Department Of Cardiothoracic Surgery Medical University Of Vienna

• Glogar Dietmar

  Department Of Cardiology Medical University Of Vienna

• Hirayama Atsushi

  Cardiovascular Division Osaka Police Hospital

• KANMATSUSE Katsuo

  Surugadai Nihon University Hospital

• Abeta Hiromi

  Department Of Cardiology Surugadai Nihon University Hospital

• Hirayama Atsushi

  Department Of Cardiology Nihon University School Of Medicine

• Kammatsuse Katsuo

  Dept Of Cardiovasology Surugadai Nihon Univ. Hosp.

• Akiyama Haruhiko

  Division Of Cardiology Department Of Medicine Nihon University School Of Medicine

• Kanmatsuse Katsuo

  Division Of Cardiovascular Medicine Department Of Medicine Nihon University School Of Medicine

• Kodama Kazuhisa

  Cardiac Intensive Care Unit Of Osaka Police Hospital

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