Resumo

EXAIRE, J Emilio et al. Impaired myocardial perfusion score and inflammatory markers in patients undergoing primary angioplasty for acute myocardial infarction. Arch. Cardiol. Méx. [online]. 2006, vol.76, n.4, pp.376-382. ISSN 1665-1731.

Background: Microcirculatory dysfunction during acute myocardial infarction is mediated by various mechanisms including inflammation, thrombus, or plaque embolization. We hypothesize that patients with acute myocardial infarction and admission Thrombolysis in Myocardial Infarction (TlMl) myocardial perfusión grade (TMP) < 2 had increased inflammatory status as measured by high sensitivity C-reactive protein (hs-CRP). Methods: From January 2002 to December 2003, 166 patients (178 lesions) were referred for primary percutaneous coronary intervention. Patients were stratified based on pre-PCI TMP < 2 or TMP ³ 2. Univariate and multi-variate predictors of in-hospital and 30-day death were determined with logistic regression. Results: Pre-PCI TMP < 2 was found in 66% vs 34% with TMP ³ 2 (P < .001). Hs-CRP levels were high in both groups but not significantly different (37.9 ± 6 vs 33.7 ± 6 mg/L, P = .63). Patients with TMP < 2 had higher WBC (12.83 ± 4.55 * 10³ vs 10.83 ± 3.00 * 10³, P = .04), lower ejection fraction (40 ± 11% vs 46 ± 12%, P < .001), and higher admission CK-MB levels (116 ± 13 ng/mL vs 55 ± 13 ng/mL, P = .006). Death occurred in 12% in the poor TMP group vs 1.8% in the good TMP group (P = .03). Advanced age, use of an intra-aortic balloon pump, and elevated admission WBC were independently associated with in-hospital and 30-day death. Conclusions: High hs-CRP levels were not associated with impaired myocardial perfusion score. Microcirculatory impairment may be related to an increased inflammatory process, independent from high hs-CRP levels.

Palavras-chave : Percutaneous intervention; Myocardial infarction; Inflammation.

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