Effect of percutaneous coronary intervention with long predilatation period on coronary flow in patients with acute ST segment elevation myocardial infartus

Objective: Coronary artery disease ranks first when the causes of death are examined worldwide. After the diagnosis of STEMI is established, prompt revascularization is urgent. It is known that the better the coronary flow and perfusion are, the better the long-term results of the patient. In our study, it was aimed to compare the effects of balloon angioplasty with long and short-term predilation on coronary flow in primary PCIs in STEMI with some determining parameters. Methods: 62 patients who applied to our clinic with the diagnosis of STEMI and underwent primary PCI were included in our study. Predilation was performed with a short-term balloon under 30 seconds in 31 patients, and a long-term balloon over 30 seconds in the other 31 patients. ST segment resolutions, laboratory parameters, troponin follow-ups and peak hours were observed in the ECG of both groups after the procedure. Parameters such as TIMI score, TIMIfc and MBG of the revascularized responsible vessel after the procedure were evaluated. Results: Participants in both groups were found to be similar in terms of features other than the investigated parameters. (p>0.05) In the time graph of the troponin value after the procedure, it was observed that those who ballooned for a long time reached the troponin peak value in the earlier hours. Percentages of ECG improvement over time in the long-term balloon group at 1,3 and 6 hours (78.71±21, 92.26±1, 96.77±1, respectively) compared to the short balloon group (60.97±2, 81, respectively). 94±1, 92.90±1) was higher. (p<0.05) In the logistic regression analysis performed to determine the factors affecting TIMIFc and MBG flow, the explanatory power of the model was between 28.7% and 43.7% for R2 and between 28.8% and 46.0% for R2, respectively. While increasing age affected TIMIfc and MBG negatively, increasing balloon time had a positive effect on TIMIfc and MBG flow. (p<0.05) Conclusion: In our study, in primary PCI applied to patients presenting with STEMI, long-term balloon predilation improved parameters such as TIMI, TIMIfc, MBG compared to short-term predilation, thus providing a better coronary flow and perfusion, and reaching the troponin peak value faster. showed a faster resolution. If similar findings are demonstrated in larger studies, standardizing the balloon duration will be beneficial in terms of STEMI and subsequent prognosis.