Comparison Between the Effect of Intracoronary Versus Intravenous Eptifibatide on the Outcome of Primary Percutaneous Coronary Intervention to Acute Anterior Myocardial Infarction

Abstract

Primary percutaneous coronary intervention (PCI) is now the established reperfusion strategy in the treatment of acute myocardial infarction with ST-segment elevation (272). Nevertheless, myocardial damage is not immediately terminated after the elimination of epicardial occlusion with successful primary PCI. It has been presumed that reperfusion injury and embolization of epicardial thrombus and plaque debris jeopardize tissue-level perfusion (273).

Although thromboembolism of proximal origin may limit microvascular perfusion (274). A thrombus may also form in the microvasculature itself. This concept may help explain why randomized trials have failed to show a beneficial effect of distal protection devices on microvascular perfusion during primary PCI, despite effective retrieval of thrombus and plaque content from epicardial coronary arteries.(275)