Evidence map›Paper›PMID 35213721›Full record

ArticleEuropean heart journal. Acute cardiovascular care2022

Effects of early myocardial reperfusion and perfusion on myocardial necrosis/dysfunction and inflammation in patients with ST-segment and non-ST-segment elevation acute coronary syndrome: results from the PLATelet inhibition and patients Outcomes (PLATO) trial.

Gorav Batra, Henrik Renlund, Vijay Kunadian, Stefan K James, Robert F Storey, P Gabriel Steg, Hugo A Katus, Robert A Harrington, C Michael Gibson, Andrzej Budaj and 2 more

Open access · bronzeAbstract read
In one paragraph

Article in European heart journal. Acute cardiovascular care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.9field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Trial
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 6 institutions in 6 countries.

Gorav BatraDepartment of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden.ORCID 0000-0002-2480-9547
Henrik RenlundUppsala Clinical Research Center, Uppsala University, Uppsala Science Park, Hubben, Dag Hammarskjölds väg 38, 751 85 Uppsala, Sweden.ORCID 0000-0002-2141-6086
Vijay KunadianTranslational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University and Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.ORCID 0000-0003-2975-6971
Stefan K JamesDepartment of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden.ORCID 0000-0003-4413-9736
Robert F StoreyDepartment of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK.
P Gabriel StegUniversité de Paris, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, French Alliance for Cardiovascular Trials, and INSERM U1148, Paris, France.
Hugo A KatusMedizinishe Klinik, Universitätsklinikum Heidelberg, Heidelberg, Germany.
Robert A HarringtonDepartment of Medicine, Stanford University, Stanford, CA, USA.
C Michael GibsonDepartment of Cardiology, Centre of Postgraduate Medical Education, Grochowski Hospital, Warsaw, Poland.
Agneta SiegbahnUppsala Clinical Research Center, Uppsala University, Uppsala Science Park, Hubben, Dag Hammarskjölds väg 38, 751 85 Uppsala, Sweden.
Lars WallentinDepartment of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden.ORCID 0000-0003-0378-6531
Uppsala University · SEBeth Israel Deaconess Medical Center · USHeidelberg University · DEInserm · FRNewcastle upon Tyne Hospitals NHS Foundation Trust · GBUniversity of Sheffield · GB

Funding

AstraZenecaBritish Heart Foundation CS/15/7/31679
6 · The paper itself

Abstract

aimsRestoration of myocardial blood flow and perfusion during percutaneous coronary intervention (PCI) measured using Thrombolysis in Myocardial Infarction (TIMI) flow grade (TFG) and perfusion grade (TMPG) is associated with improved outcomes in acute coronary syndrome (ACS). Associations between TFG/TMPG and changes in biomarkers reflecting myocardial damage/dysfunction and inflammation is unknown. METHODS AND

resultsAmong 2606 patients included, TFG was evaluated in 2198 and TMPG in 1874 with ST-segment elevation myocardial infarction (STEMI) or non-ST-segment ACS (NSTE-ACS). Biomarkers reflecting myocardial necrosis [troponin T (TnT)], myocardial dysfunction [N-terminal prohormone brain natriuretic peptide (NT-proBNP)], inflammation [interleukin-6 (IL-6) and C-reactive protein (CRP)], and oxidative stress/ageing/inflammation [growth differentiation factor-15 (GDF-15)] were measured at baseline, discharge, and 1- and 6-month post-randomization. Associations between TFG/TMPG and changes in biomarker levels were evaluated using the Mann-Whitney-Wilcoxon signed test. In total, 1423 (54.6%) patients had STEMI and 1183 (45.4%) NSTE-ACS. Complete reperfusion after PCI with TFG = 3 was achieved in 1110 (85.3%) with STEMI and in 793 (88.5%) with NSTE-ACS. Normal myocardial perfusion with TMPG = 3 was achieved in 475 (41.6%) with STEMI and in 396 (54.0%) with NSTE-ACS. Levels of TnT, NT-proBNP, IL-6, CRP, and GDF-15 were substantially lower at discharge in patients with complete vs. incomplete TFG and STEMI (P < 0.01). This pattern was not observed for patients with NSTE-ACS. Patients with normal vs. abnormal TMPG and NSTE-ACS had lower levels of NT-proBNP at discharge (P = 0.01).

conclusionsSuccessful restoration of epicardial blood flow in STEMI was associated with less myocardial necrosis/dysfunction and inflammation. Attainment of normal myocardial perfusion was associated with less myocardial dysfunction in NSTE-ACS.

Indexed as

Acute Coronary SyndromeMyocardial InfarctionPercutaneous Coronary InterventionST Elevation Myocardial InfarctionBiomarkersCoronary AngiographyElectrocardiographyGrowth Differentiation Factor 15HumansInflammationInterleukin-6Myocardial ReperfusionTroponin TBiomarkersGrowth Differentiation Factor 15Interleukin-6Troponin TAcute coronary syndromeBiomarkersPercutaneous coronary interventionTIMI flow gradeTIMI myocardial perfusion grade

Identifiers

PMID35213721
PMCPMC9173680
OpenAlexW4210885221

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.