Effect of Pressure-controlled intermittent Coronary Sinus Occlusion (PiCSO) on infarct size in anterior STEMI: PiCSO in ACS study

Mohaned Egred, Alan Bagnall, Ioakim Spyridopoulos, Ian F. Purcell, Rajiv Das, Nick Palmer, Ever D. Grech, Ajay Jain, Gregg W. Stone, Robin Nijveldt, Thomas McAndrew, Azfar Zaman

Research output: Contribution to journalArticlepeer-review

27 Scopus citations

Abstract

Background: The aim of this clinical research was to investigate the effects of Pressure-controlled intermittent Coronary Sinus Occlusion (PiCSO) on infarct size at 5 days after primary percutaneous coronary intervention (pPCI) in patients with ST-segment elevation myocardial infarction (STEMI). Methods and results: This comparative study was carried out in four UK hospitals. Forty-five patients with anterior STEMI presenting within 12 h of symptom onset received pPCI plus PiCSO (initiated after reperfusion; n = 45) and were compared with a propensity score-matched control cohort from INFUSE-AMI (n = 80). Infarct size (% of LV mass, median [interquartile range]) measured by cardiac magnetic resonance (CMR) at day 5 was significantly lower in the PiCSO group (14.3% [95% CI 9.2–19.4%] vs. 21.2% [95% CI 18.0–24.4%]; p = 0.023). There were no major adverse cardiac events (MACE) related to the PiCSO intervention. Conclusions: PiCSO, as an adjunct to pPCI, was associated with a lower infarct size at 5 days after anterior STEMI in a propensity score-matched population.

Original languageEnglish
Article number100526
JournalIJC Heart and Vasculature
Volume28
DOIs
StatePublished - Jun 2020
Externally publishedYes

Keywords

  • Infarct size reduction
  • Pressure-controlled intermittent coronary sinus occlusion (PICSO)
  • ST-segment elevation myocardial infarction (STEMI)

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