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Clinics ; 66(10): 1729-1734, 2011. graf, tab
Artigo em Inglês | LILACS | ID: lil-601906

RESUMO

OBJECTIVE: This retrospective study aimed to investigate the relationship between admission levels of serum y-glutamyltransferase and poor myocardial perfusion after primary percutaneous coronary intervention in patients with acute myocardial infarction. INTRODUCTION: Reperfusion injury caused by free radical release and increased oxidative stress is responsible for the pathophysiology of the no-reflow phenomenon in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention. Serum ϒ-glutamyltransferase is an established marker of increased oxidative stress. METHODS: The study population consisted of 80 patients (64 men and 16 women, mean age = 67.5 + 6.6 years) with thrombolysis in myocardial infarction 0/1 flow pre-procedurally. The patients were divided into two groups according to thrombolysis in myocardial perfusion grades that were assessed immediately following primary percutaneous coronary intervention. The two groups (group 1 and group 2) each consisted of 40 patients with thrombolysis in myocardial perfusion grades 0-1 and thrombolysis in myocardial perfusion grades 2-3, respectively. RESULTS: Admission pain to balloon time, ϒ-glutamyltransferase and creatine kinase-MB isoenzyme levels of group 1 patients were significantly higher than those of group 2 patients. Pain to balloon time, ϒ-glutamyltransferase, peak creatine kinase-MB isoenzyme, low left ventricular ejection fraction and poor pre-procedural thrombolysis in myocardial infarction grade were significantly associated with poor myocardial perfusion by univariate analysis. However, only pain to balloon time and ϒ-glutamyltransferase levels showed a significant independent association with poor myocardial perfusion by backward logistic regression analysis. Adjusted odds ratios were calculated as 4.92 for pain to balloon time and 1.13 for ϒ-glutamyltransferase. CONCLUSION: High admission ϒ-glutamyltransferase levels are associated with poor myocardial perfusion in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention, particularly in patients with prolonged pain to balloon time.


Assuntos
Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/terapia , Reperfusão Miocárdica/reabilitação , gama-Glutamiltransferase/sangue , Fatores Etários , Angioplastia Coronária com Balão/efeitos adversos , Biomarcadores/sangue , Angiografia Coronária , Creatina Quinase Forma MB/sangue , Ecocardiografia , Métodos Epidemiológicos , Infarto do Miocárdio/enzimologia , Fenômeno de não Refluxo/etiologia , Fenômeno de não Refluxo/fisiopatologia , Estudos Retrospectivos , Terapia Trombolítica , Fatores de Tempo
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