Importance of infarct size versus other variables for clinical outcomes after PPCI in STEMI patients

Despite promising experimental studies and encouraging proof-of-concept clinical trials, interventions aimed at limiting infarct size have failed to improve clinical outcomes in patients with ST-elevation myocardial infarction (STEMI). Our objective was to examine whether variables (cardiovascular r...

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Bibliographic Details
Published in:Basic research in cardiology 2020-01, Vol.115 (1), p.4-4, Article 4
Main Authors: Bochaton, Thomas, Claeys, Marc J., Garcia-Dorado, David, Mewton, Nathan, Bergerot, Cyrille, Jossan, Claire, Amaz, Camille, Boussaha, Inesse, Thibault, Hélène, Ovize, Michel
Format: Article
Language:English
Subjects:
Aged
Angiotensin
Angiotensin-converting enzyme inhibitors
Cardiology
Cardiovascular diseases
Clinical outcomes
Clinical trials
Congestive heart failure
Cyclosporins
Drug delivery systems
Enzyme inhibitors
Europe - epidemiology
Female
Health risks
Heart failure
Heart Failure - epidemiology
Heart Failure - etiology
Humans
Hypertension
Incidence
Intravenous administration
Male
Medicine
Medicine & Public Health
Middle Aged
Multivariate analysis
Myocardial infarction
Myocardium - pathology
Original Contribution
Patients
Peptidyl-dipeptidase A
Population studies
Prognosis
Renal function
Risk analysis
Risk factors
Size reduction
ST Elevation Myocardial Infarction - complications
ST Elevation Myocardial Infarction - diagnosis
ST Elevation Myocardial Infarction - pathology
ST Elevation Myocardial Infarction - therapy
Variables
Ventricular Remodeling
Weight
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Summary:Despite promising experimental studies and encouraging proof-of-concept clinical trials, interventions aimed at limiting infarct size have failed to improve clinical outcomes in patients with ST-elevation myocardial infarction (STEMI). Our objective was to examine whether variables (cardiovascular risk factors, comorbidities, post-procedural variables, cotreatments) might be associated with clinical outcomes in STEMI patients independently from infarct size reduction. The present study was based on a post hoc analysis of the CIRCUS trial database (Clinicaltrials.gov NCT01502774) that assessed the clinical benefit of a single intravenous bolus of cyclosporine in 969 patients with anterior STEMI. Since cyclosporine had no detectable effect on clinical outcomes as well as on any measured variable, we here considered the whole study population as one group. Multivariate analysis was performed to address the respective weight of infarct size and variables in clinical outcomes. Multivariate analysis revealed that several variables (including gender, hypertension, renal dysfunction, TIMI flow grade post-PCI 
ISSN:0300-8428
1435-1803
DOI:10.1007/s00395-019-0764-8