{"id":"4c27fc26dcde","type":"article","url":"https://hartvaat.nl/2016/12/15/infarctgrootte-en-linkerkamerremodellering-na-preventieve-pci/","title":"Infarctgrootte en linkerkamerremodellering na preventieve PCI","title_en":"Infarct size and left ventricular remodelling after preventive percutaneous coronary intervention.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":["acuut-hartfalen","bloeddrukbehandeling","farmaco-economie","hartrevalidatie","inflammatie","laminopathie","myocardinfarct","ouderen","percutane-coronaire-interventie","primaire-preventie","secundaire-preventie","stemi"],"journal":"Heart (British Cardiac Society)","doi":"10.1136/heartjnl-2015-308660","source_url":"https://doi.org/10.1136/heartjnl-2015-308660","authors":["Kenneth Mangion","David Carrick","Barry W Hennigan","Alexander R Payne","John McClure","Maureen Mason","Rajiv Das","Rebecca Wilson","Richard J Edwards","Mark C Petrie","Margaret McEntegart","Hany Eteiba","Keith G Oldroyd","Colin Berry"],"significance":5,"published":"2016-12-15","source_date":"2016-12-15","image":"","kennis":["https://hartvaat.nl/kennis/cardiometabool/diabetes-en-cardiovasculair-risico/"],"congress":"","summary_en":"This study examined the effect of preventive PCI of non-culprit lesions on infarct size and LV remodeling, comparing complete with culprit-only revascularization on myocardial tissue-level outcomes.","created":"2026-07-03T10:26:28Z","updated":"2026-07-03T13:25:47Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Studie naar het effect van preventieve PCI op infarctgrootte en linkerkamerremodellering. Onderzoekt of vroege interventie bij niet-culprit laesies de myocardschade kan beperken.","abstract_original":"OBJECTIVE: We hypothesised that, compared with culprit-only primary percutaneous coronary intervention (PCI), additional preventive PCI in selected patients with ST-elevation myocardial infarction with multivessel disease would not be associated with iatrogenic myocardial infarction, and would be associated with reductions in left ventricular (LV) volumes in the longer term. METHODS: In the preventive angioplasty in myocardial infarction trial (PRAMI; ISRCTN73028481), cardiac magnetic resonance (CMR) was prespecified in two centres and performed (median, IQR) 3 (1, 5) and 209 (189, 957) days after primary PCI. RESULTS: From 219 enrolled patients in two sites, 84% underwent CMR. 42 (50%) were randomised to culprit-artery-only PCI and 42 (50%) were randomised to preventive PCI. Follow-up CMR scans were available in 72 (86%) patients. There were two (4.8%) cases of procedure-related myocardial infarction in the preventive PCI group. The culprit-artery-only group had a higher proportion of anterior myocardial infarctions (MIs) (55% vs 24%). Infarct sizes (% LV mass) at baseline and follow-up were similar. At follow-up, there was no difference in LV ejection fraction (%, median (IQR), (culprit-artery-only PCI vs preventive PCI) 51.7 (42.9, 60.2) vs 54.4 (49.3, 62.8), p=0.23), LV end-diastolic volume (mL/m2, 69.3 (59.4, 79.9) vs 66.1 (54.7, 73.7), p=0.48) and LV end-systolic volume (mL/m2, 31.8 (24.4, 43.0) vs 30.7 (23.0, 36.3), p=0.20). Non-culprit angiographic lesions had low-risk Syntax scores and 47% had non-complex characteristics. CONCLUSIONS: Compared with culprit-only PCI, non-infarct-artery MI in the preventive PCI strategy was uncommon and LV volumes and ejection fraction were similar."}