2015
Effect of Ischemia Duration and Door-to-Balloon Time on Myocardial Perfusion in ST-Segment Elevation Myocardial Infarction An Analysis From HORIZONS-AMI Trial (Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction)
Prasad A, Gersh BJ, Mehran R, Brodie BR, Brener SJ, Dizon JM, Lansky AJ, Witzenbichler B, Kornowski R, Guagliumi G, Dudek D, Stone GW. Effect of Ischemia Duration and Door-to-Balloon Time on Myocardial Perfusion in ST-Segment Elevation Myocardial Infarction An Analysis From HORIZONS-AMI Trial (Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction). JACC Cardiovascular Interventions 2015, 8: 1966-1974. PMID: 26738667, DOI: 10.1016/j.jcin.2015.08.031.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCoronary CirculationDrug-Eluting StentsFemaleHumansMaleMetalsMicrocirculationMiddle AgedMyocardial InfarctionMyocardial Perfusion ImagingPercutaneous Coronary InterventionProspective StudiesProsthesis DesignRisk AssessmentRisk FactorsStentsTime FactorsTime-to-TreatmentTreatment OutcomeConceptsPrimary percutaneous coronary interventionMyocardial blush gradePrimary PCIHORIZONS-AMI trialMBG 0/1Balloon timeIndependent predictorsAnterior infarctionMyocardial perfusionST-segment elevation myocardial infarction (STEMI) patientsST-segment elevation myocardial infarctionHigher clinical risk profileElevation myocardial infarction patientsMyocardial Infarction (TIMI) risk scoreClinical risk profileMechanical reperfusion therapyReference vessel diameterElevation myocardial infarctionPercutaneous coronary interventionST-segment elevationEpicardial blood flowMinimum lumen diameterMyocardial infarction patientsMicrovascular reperfusionBlush gradePrognostic utility of myocardial blush grade after PCI in patients with NSTE‐ACS: Analysis from the ACUITY trial
Ng VG, Lansky AJ, Toro S, Parise H, Cristea E, Mehran R, Stone GW. Prognostic utility of myocardial blush grade after PCI in patients with NSTE‐ACS: Analysis from the ACUITY trial. Catheterization And Cardiovascular Interventions 2015, 88: 215-224. PMID: 25641255, DOI: 10.1002/ccd.25865.Peer-Reviewed Original ResearchMeSH KeywordsAcute Coronary SyndromeAgedChi-Square DistributionCoronary AngiographyCoronary CirculationCoronary VesselsFemaleHumansKaplan-Meier EstimateMaleMiddle AgedMultivariate AnalysisMyocardial Perfusion ImagingNon-ST Elevated Myocardial InfarctionOdds RatioPercutaneous Coronary InterventionPredictive Value of TestsProportional Hazards ModelsRisk AssessmentRisk FactorsTreatment OutcomeConceptsMyocardial blush gradePercutaneous coronary interventionST-segment elevation myocardial infarctionNSTE-ACS patientsComposite ischemiaMBG 0/1Non-ST segment elevation acute coronary syndromesSegment elevation acute coronary syndromesElevation acute coronary syndromeFinal myocardial blush gradeIndependent angiographic core laboratoryNet adverse clinical eventsNon-CABG major bleedingNormal epicardial flowOutcomes of patientsTIMI 3 flowAcute coronary syndromeIschemia-driven revascularizationAdverse clinical eventsElevation myocardial infarctionNormal myocardial perfusionAngiographic core laboratoryHigh rateACUITY trialMajor bleeding
2014
Implications of ventricular arrhythmia “bursts” with normal epicardial flow, myocardial blush, and ST-segment recovery in anterior ST-elevation myocardial infarction reperfusion: A biosignature of direct myocellular injury “downstream of downstream”
Majidi M, Kosinski AS, Al-Khatib SM, Smolders L, Cristea E, Lansky AJ, Stone GW, Mehran R, Gibbons RJ, Crijns HJ, Wellens HJ, Gorgels AP, Krucoff MW. Implications of ventricular arrhythmia “bursts” with normal epicardial flow, myocardial blush, and ST-segment recovery in anterior ST-elevation myocardial infarction reperfusion: A biosignature of direct myocellular injury “downstream of downstream”. European Heart Journal Acute Cardiovascular Care 2014, 4: 51-59. PMID: 25063574, DOI: 10.1177/2048872614532414.Peer-Reviewed Original ResearchConceptsST-segment recoveryMyocardial blush gradeST-segment elevation myocardial infarctionNormal epicardial flowTIMI 3 flowPercutaneous coronary interventionEpicardial flowLarger ISOptimal reperfusionVentricular arrhythmiasMyocellular injuryFinal TIMI 3 flowMyocardial Infarction 3 flowAnterior STEMI patientsElevation myocardial infarctionReperfusion ventricular arrhythmiasInfarct size assessmentMyocardial infarction reperfusionContinuous ECG monitoringMBG 2/3Myocardial ISBlush gradeSTEMI patientsCoronary interventionMyocardial reperfusionImpact of Nonculprit Vessel Myocardial Perfusion on Outcomes of Patients Undergoing Percutaneous Coronary Intervention for Acute Coronary Syndromes Analysis From the ACUITY Trial (Acute Catheterization and Urgent Intervention Triage Strategy)
Lansky AJ, Ng VG, Meller S, Xu K, Fahy M, Feit F, Ohman EM, White HD, Mehran R, Bertrand ME, Desmet W, Hamon M, Stone GW. Impact of Nonculprit Vessel Myocardial Perfusion on Outcomes of Patients Undergoing Percutaneous Coronary Intervention for Acute Coronary Syndromes Analysis From the ACUITY Trial (Acute Catheterization and Urgent Intervention Triage Strategy). JACC Cardiovascular Interventions 2014, 7: 266-275. PMID: 24650400, DOI: 10.1016/j.jcin.2013.08.016.Peer-Reviewed Original ResearchMeSH KeywordsAcute Coronary SyndromeAgedCardiac CatheterizationCoronary AngiographyCoronary CirculationDouble-Blind MethodElectrocardiographyEmergenciesFemaleFollow-Up StudiesHumansMaleMiddle AgedMyocardial Perfusion ImagingPercutaneous Coronary InterventionPericardiumPractice Guidelines as TopicPrognosisProspective StudiesSurvival RateTriageUnited StatesConceptsPercutaneous coronary interventionMyocardial blush gradeNSTE-ACS patientsMBG 0/1Myocardial perfusionACUITY trialNonculprit vesselsCulprit vesselCoronary interventionSegment elevation acute coronary syndrome patientsST-segment elevation myocardial infarction (STEMI) patientsElevation acute coronary syndrome patientsOutcomes of PCIAcute Coronary Syndromes AnalysisTIMI flow grade 3Worse baseline clinical characteristicsAcute coronary syndrome patientsElevation myocardial infarction patientsLong-term mortality ratesInfarct-related vesselBaseline clinical characteristicsOutcomes of patientsCoronary syndrome patientsRisk-stratify patientsMyocardial infarction patients
2013
Complementary prognostic utility of myocardial blush grade and ST-segment resolution after primary percutaneous coronary intervention: Analysis from the HORIZONS-AMI trial
Brener SJ, Dizon JM, Mehran R, Guerchicoff A, Lansky AJ, Farkouh M, Brodie B, Guagliumi G, Witzenbichler B, Fahy M, Parise H, Stone GW. Complementary prognostic utility of myocardial blush grade and ST-segment resolution after primary percutaneous coronary intervention: Analysis from the HORIZONS-AMI trial. American Heart Journal 2013, 166: 676-683. PMID: 24093847, DOI: 10.1016/j.ahj.2013.07.025.Peer-Reviewed Original ResearchConceptsPrimary percutaneous coronary interventionST-segment resolutionMyocardial blush gradePrimary PCIPercutaneous coronary interventionBlush gradeHORIZONS-AMIMBG 2/3Coronary interventionPrognostic utilityMajor adverse cardiac eventsMyocardial blush grade 2/3ST-elevation myocardial infarctionHORIZONS-AMI trialAdverse cardiac eventsPredictors of deathIndependent prognostic significanceComplementary prognostic informationLong-term outcomesLong-term survivalCardiac eventsReperfusion successIndependent predictorsGrade 2/3Multivariable analysisImplications of Myocardial Reperfusion on Survival in Women Versus Men With Acute Myocardial Infarction Undergoing Primary Coronary Intervention
Meller SM, Lansky AJ, Costa RA, Soffler M, Costantini CO, Brodie BR, Cox DA, Stuckey TD, Fahy M, Grines CL, Stone GW. Implications of Myocardial Reperfusion on Survival in Women Versus Men With Acute Myocardial Infarction Undergoing Primary Coronary Intervention. The American Journal Of Cardiology 2013, 112: 1087-1092. PMID: 23827398, DOI: 10.1016/j.amjcard.2013.05.052.Peer-Reviewed Original ResearchConceptsPrimary percutaneous coronary interventionMyocardial blush gradeAcute myocardial infarctionIndependent predictorsMyocardial perfusionPrimary angioplastyCoronary interventionMyocardial infarctionMyocardial Infarction 3 flowEnhanced survival benefitWomen Versus MenPrimary coronary interventionLong-term mortalityPercutaneous coronary interventionFinal ThrombolysisMBG 2/3Blush gradeLate mortalitySurvival benefitMyocardial reperfusionMyocardial salvageGender-specific responsesLate survivalInterventional strategiesMortality rate
2012
Operator Versus Core Laboratory Assessment of Angiographic Reperfusion Markers in Patients Undergoing Primary Percutaneous Coronary Intervention for ST-Segment–Elevation Myocardial Infarction
Brener SJ, Cristea E, Lansky AJ, Fahy M, Mehran R, Stone GW. Operator Versus Core Laboratory Assessment of Angiographic Reperfusion Markers in Patients Undergoing Primary Percutaneous Coronary Intervention for ST-Segment–Elevation Myocardial Infarction. Circulation Cardiovascular Interventions 2012, 5: 563-569. PMID: 22828707, DOI: 10.1161/circinterventions.112.969022.Peer-Reviewed Original ResearchMeSH KeywordsAgedAnticoagulantsAntithrombinsCoronary AngiographyCoronary CirculationDrug-Eluting StentsElectrocardiographyFemaleHeparinHirudinsHumansMaleMiddle AgedMultivariate AnalysisMyocardial InfarctionObserver VariationPaclitaxelPeptide FragmentsPercutaneous Coronary InterventionPredictive Value of TestsPrognosisRecombinant ProteinsTubulin ModulatorsConceptsPrimary percutaneous coronary interventionMyocardial blush gradeST-segment elevation myocardial infarctionPercutaneous coronary interventionTIMI flowMyocardial infarctionCoronary interventionMBG 2Post-PCI myocardial blush gradePost-PCI TIMI 3 flowPrimary PCIFinal myocardial blush gradeFinal TIMI flow 0Pre-PCI TIMI flowCore laboratory assessmentFinal TIMI flowRelative prognostic utilityTIMI flow 0Myocardial infarction (TIMI) flowTIMI 3 flowElevation myocardial infarctionImportant prognostic indicatorHarmonizing OutcomesMBG 0Reperfusion marker
2007
Comparison of Myocardial Reperfusion in Patients Undergoing Percutaneous Coronary Intervention in ST-Segment Elevation Acute Myocardial Infarction With Versus Without Diabetes Mellitus (from the EMERALD Trial)
Marso SP, Miller T, Rutherford BD, Gibbons RJ, Qureshi M, Kalynych A, Turco M, Schultheiss HP, Mehran R, Krucoff MW, Lansky AJ, Stone GW. Comparison of Myocardial Reperfusion in Patients Undergoing Percutaneous Coronary Intervention in ST-Segment Elevation Acute Myocardial Infarction With Versus Without Diabetes Mellitus (from the EMERALD Trial). The American Journal Of Cardiology 2007, 100: 206-210. PMID: 17631071, DOI: 10.1016/j.amjcard.2007.02.080.Peer-Reviewed Original ResearchConceptsPrimary percutaneous coronary interventionST-segment elevation myocardial infarctionElevation myocardial infarctionPrimary PCIMyocardial blush gradeCongestive heart failurePercutaneous coronary interventionMyocardial infarctionNondiabetic patientsDiabetes mellitusInfarct sizeMyocardial perfusionBlush gradeCoronary interventionHeart failureMyocardial reperfusionDiabetic patientsAcute ST-segment elevation myocardial infarctionST-segment elevation acute myocardial infarctionFinal myocardial blush gradeVersus Without Diabetes MellitusElevation acute myocardial infarctionSevere congestive heart failureDistal embolic protectionFinal infarct sizeRelation Between Leucocyte Count, Myonecrosis, Myocardial Perfusion, and Outcomes Following Primary Angioplasty
Prasad A, Stone GW, Stuckey TD, Costantini CO, Mehran R, Garcia E, Tcheng JE, Cox DA, Grines CL, Lansky AJ, Gersh BJ. Relation Between Leucocyte Count, Myonecrosis, Myocardial Perfusion, and Outcomes Following Primary Angioplasty. The American Journal Of Cardiology 2007, 99: 1067-1071. PMID: 17437729, DOI: 10.1016/j.amjcard.2006.11.063.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAngioplasty, Balloon, CoronaryCoronary AngiographyCoronary CirculationCreatine KinaseFemaleForecastingHumansLeukocyte CountLeukocytosisMaleMicrocirculationMiddle AgedMyocardial InfarctionMyocardial ReperfusionProspective StudiesRetrospective StudiesSmokingSurvival RateTreatment OutcomeConceptsPrimary percutaneous coronary interventionPrimary PCIBaseline leukocyte countAcute myocardial infarctionHigh leukocyte countLeukocyte countMyocardial perfusionMyocardial blush grade 2/3Myocardial infarction (TIMI) flowMyocardial blush gradePredictors of mortalityPercutaneous coronary interventionNegative prognostic factorPeak creatine phosphokinaseBaseline leukocytosisCADILLAC trialBlush gradePrimary angioplastyCoronary interventionCurrent smokersIndependent predictorsPrognostic factorsReperfusion successClinical outcomesGrade 2/3
2006
Relationship between infarct artery location, epicardial flow, and myocardial perfusion after primary percutaneous revascularization in acute myocardial infarction
Kandzari DE, Tcheng JE, Gersh BJ, Cox DA, Stuckey T, Turco M, Mehran R, Garcia E, Zimetbaum P, McGlaughlin MG, Lansky AJ, Costantini CO, Grines CL, Stone GW, Investigators F. Relationship between infarct artery location, epicardial flow, and myocardial perfusion after primary percutaneous revascularization in acute myocardial infarction. American Heart Journal 2006, 151: 1288-1295. PMID: 16781238, DOI: 10.1016/j.ahj.2005.08.017.Peer-Reviewed Original ResearchConceptsPrimary percutaneous coronary interventionAcute myocardial infarctionPrimary PCIST-segment resolutionMyocardial infarctionReperfusion successVentricular functionClinical outcomesCollateral flowAnterior infarctionMyocardial perfusionArtery locationFinal TIMI 3 flowIschemic target vessel revascularizationMajor adverse cardiac eventsReduced left ventricular functionRight coronary artery distributionPrimary percutaneous revascularizationAdverse cardiac eventsBaseline clinical characteristicsTarget vessel revascularizationTIMI 3 flowMyocardial blush gradePowerful independent predictorPercutaneous coronary intervention
2005
Impact of diabetes mellitus on myocardial perfusion after primary angioplasty in patients with acute myocardial infarction
Prasad A, Stone GW, Stuckey TD, Costantini CO, Zimetbaum PJ, McLaughlin M, Mehran R, Garcia E, Tcheng JE, Cox DA, Grines CL, Lansky AJ, Gersh BJ. Impact of diabetes mellitus on myocardial perfusion after primary angioplasty in patients with acute myocardial infarction. Journal Of The American College Of Cardiology 2005, 45: 508-514. PMID: 15708696, DOI: 10.1016/j.jacc.2004.10.054.Peer-Reviewed Original ResearchConceptsPrimary PCIPrimary percutaneous coronary interventionST-segment elevation resolutionMyocardial blush gradeAcute myocardial infarctionDiabetes mellitusMyocardial perfusionMyocardial infarctionIndependent predictorsGrade 3Late Angioplasty Complications (CADILLAC) trialTIMI flow grade 3Infarct-related arteryAbnormal myocardial perfusionPercutaneous coronary interventionAbciximab administrationControlled AbciximabPostprocedural ThrombolysisBlush gradePrimary angioplastyComplications TrialCoronary interventionReperfusion successMyocardial reperfusionPoor prognosis
2004
Frequency, correlates, and clinical implications of myocardial perfusion after primary angioplasty and stenting, with and without glycoprotein IIb/IIIa inhibition, in acute myocardial infarction
Costantini CO, Stone GW, Mehran R, Aymong E, Grines CL, Cox DA, Stuckey T, Turco M, Gersh BJ, Tcheng JE, Garcia E, Griffin JJ, Guagliumi G, Leon MB, Lansky AJ. Frequency, correlates, and clinical implications of myocardial perfusion after primary angioplasty and stenting, with and without glycoprotein IIb/IIIa inhibition, in acute myocardial infarction. Journal Of The American College Of Cardiology 2004, 44: 305-312. PMID: 15261923, DOI: 10.1016/j.jacc.2004.03.058.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionIIb/IIIa inhibitorsTissue-level perfusionMyocardial perfusionPrimary angioplastyMyocardial infarctionGlycoprotein IIb/IIIa inhibitionGlycoprotein IIb/IIIa inhibitorsGP IIb/IIIa inhibitorsClinical implicationsIIb/IIIa inhibitionSimilar long-term mortalityLarge-scale prospective studiesMechanical reperfusion strategiesLong-term mortalityMyocardial blush gradeMinority of patientsNormal myocardial perfusionDistinct risk categoriesBlush gradePrimary PCIReperfusion strategyMyocardial reperfusionBalloon angioplastyPrognostic importance830-5 The impact of myocardial blush grade on clinical outcomes of patients treated with saphenous vein grafts and thrombotic native coronary arteries: Analysis from the X-TRACT trial
Tsuchiya Y, Lansky A, Costa R, Mehran R, Negoita M, Cristea E, Marginean H, Corral M, Tarawali M, Babb J, Cox D, Stone G. 830-5 The impact of myocardial blush grade on clinical outcomes of patients treated with saphenous vein grafts and thrombotic native coronary arteries: Analysis from the X-TRACT trial. Journal Of The American College Of Cardiology 2004, 43: a72. DOI: 10.1016/s0735-1097(04)90300-2.Peer-Reviewed Original Research
2002
Impact of normalized myocardial perfusion after successful angioplasty in acute myocardial infarction
Stone GW, Peterson MA, Lansky AJ, Dangas G, Mehran R, Leon MB. Impact of normalized myocardial perfusion after successful angioplasty in acute myocardial infarction. Journal Of The American College Of Cardiology 2002, 39: 591-597. PMID: 11849856, DOI: 10.1016/s0735-1097(01)01779-x.Peer-Reviewed Original ResearchConceptsPrimary percutaneous coronary interventionTIMI 3 flowAcute myocardial infarctionMyocardial infarctionMyocardial perfusionMyocardial blushSuccessful angioplastyAngiographic myocardial blush gradeOne-year cumulative mortalityEpicardial coronary flowMyocardial blush scoreNormal myocardial blushHigh-risk featuresHigh-risk patientsMyocardial blush gradeAbnormal myocardial perfusionMyocardial perfusion gradePercutaneous coronary interventionSurvival of patientsNormal myocardial perfusionTIMI 0Blush gradeCardiogenic shockInfarct arteryCoronary intervention