Important factors for salvaging myocardium in patients with acute myocardial infarction.

Background: This study was designed to evaluate the factors that affect myocardial salvage after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI).

Methods And Results: One hundred and eighty-three patients with AMI who had undergone successful PCI were recruited for this study. Patients underwent (99m)Tc-pyrophosphate single photon emission computed tomography (SPECT) on the third day and (99m)Tc-MIBI SPECT on the sixth day after admission. In the 20 SPECT segments, the summed defect score (TDS) and extent score (ES) of AMI segments were determined and the percentage of the salvaged myocardium was calculated based on the TDS and ES. We performed multivariate analysis to evaluate factors that can affect myocardial salvage. Multivariate analysis was performed among the value of myocardial salvage rate and the 15 clinical variables. Administration of nicorandil (p=0.006), prodromal angina (p<0.001), and high TIMI grade (p<0.001) had significant positive correlation to myocardial salvage rate. Use of a distal protection device had a significant negative correlation with myocardial salvage rate (p=0.006).

Conclusions: The presence of high TIMI grade before PCI and prodromal angina are very important for salvaging myocardium. Furthermore, administration of nicorandil is important in salvaging myocardium in patients with AMI.