Response by Traverse and Garberich to Letter Regarding Article, "NHLBI-Sponsored Randomized Trial of Postconditioning During Primary Percutaneous Coronary Intervention for ST-Elevation Myocardial Infarction".
Response by Traverse and Garberich to Letter Regarding Article, "NHLBI-Sponsored Randomized Trial of Postconditioning During Primary Percutaneous Coronary Intervention for ST-Elevation Myocardial Infarction".
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Traverse 和 Garberich 对有关文章“NHLBI 赞助的 ST 段抬高型心肌梗死初次经皮冠状动脉介入治疗期间的后处理随机试验”的信件的回应。
DOI：
10.1161/circresaha.119.314860
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发表时间：
2019
影响因子：
20.1
通讯作者：
Garberich,RossF
中科院分区：
文献类型：
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作者：
Traverse,JayH;Garberich,RossF
我们感谢楼博士和周博士对我们国家心肺血液研究所赞助的后适应试验的评论。2在我们的研究中，我们观察到在直接经皮冠状动脉介入治疗时随机分配到后处理的ST段抬高型心肌梗死（STEMI）患者在12个月时通过心脏磁共振成像评估时，左心室（LV）重构改善，并且与对照组相比，这些患者梗死区的微血管阻塞较少。然而，在3个月时间点未观察到这些对重塑的有利影响。作者质疑抽吸血栓切除术中有利于对照组的差异是否（24 [42%]对比15 [23%]例受试者; P= 0.034）是我们未能在3个月时间点观察到类似的重构改善的原因。作者引用了几项试验，证明了STEMI期间抽吸血栓切除术对LV体积3或微血管阻塞4，5的益处。Kondo等人3比较了109例接受抽吸血栓切除术和经皮腔内冠状动脉成形术的连续STEMI患者与86例接受直接经皮腔内冠状动脉成形术的历史对照组。他们观察到，左心室舒张末期容积指数增加> 20%的左心室不良重构在对照组中发生的频率明显更高。
We thank Drs Lou and Zhou for their comments1 regarding our National Heart, Lung, and Blood Institute-sponsored trial of postconditioning. 2 In our study, we observed that patients with ST-segment–elevation myocardial infarction (STEMI) randomized to postconditioning at the time of primary percutaneous coronary intervention experienced improved left ventricular (LV) remodeling when evaluated at 12 months by cardiac magnetic resonance imaging and that those patients had less microvascular obstruction in the infarct zone compared with the control group. However, these favorable effects on remodeling were not observed at the 3-month time point. The authors questioned whether the disparity in aspiration thrombectomy that favored the control group (24 [42%] versus 15 [23%] subjects; P= 0.034) was responsible for our failure to observe a similar improvement in remodeling at the 3-month time point.The authors cited several trials demonstrating a benefit of aspiration thrombectomy on LV volumes3 or microvascular obstruction 4, 5 during STEMI. Kondo et al3 compared 109 consecutive STEMI patients undergoing aspiration thrombectomy and percutaneous transluminal coronary angioplasty to a historical control group of 86 patients undergoing primary percutaneous transluminal coronary angioplasty. They observed that adverse LV remodeling defined as a> 20% increase in LV end-diastolic volume index, occurred significantly more frequently in the control group.