Aborted myocardial infarction in patients undergoing primary percutaneous coronary intervention

  • Małgorzata Pyda 1st Department of Cardiology of the Poznan University of Medical Sciences, Poland
  • Stefan Grajek 1st Department of Cardiology of the Poznan University of Medical Sciences, Poland
  • Weronika Oleśkowska-Florek Department of Cardiology of Public Specialized Health Care Center, Inowrocław, Poland
  • Maciej Lesiak 1st Department of Cardiology of the Poznan University of Medical Sciences, Poland
  • Andrzej Siniawski 1st Department of Cardiology of the Poznan University of Medical Sciences, Poland
  • Adrian Gwizdała 1st Department of Cardiology of the Poznan University of Medical Sciences, Poland
  • Marek Grygier 1st Department of Cardiology of the Poznan University of Medical Sciences, Poland
  • Aleksander Araszkiewicz 1st Department of Cardiology of the Poznan University of Medical Sciences, Poland
Keywords: STEMI, primary PCI, aborted MI


Introduction. The outcome of patients with ST-elevation myocardial infarction (STEMI) strongly depends on a successful reperfusion. In some patients receiving an effective treatment myocardial infarction can be aborted.Aim. The aim of the study was to estimate the incidence, clinical outcome, prognosis and inflammatory response in patients with aborted MI.Material and methods. 119 consecutive patients with STEMI treated with a primary percutaneous coronary intervention (pPCI) were enrolled in the study. Aborted MI was diagnosed when the maximal increase in cardiac enzymes (CK-MB) was up to twice the upper limit of normal (CK-MB ? 50 U/I) and at least 50% reduction of ST-segment deviation was observed within 90 min of pPCI.Results. Aborted MI was diagnosed in 16 subjects (13.4%). Patients with the aborted MI had lower serum troponin I levels (p < 0.0001). The time to treatment was significantly shorter in the aborted MI group (101 min vs. 220 min, p < 0.00001). Patients with aborted MI had a lower corrected TIMI frame count (p < 0.05) and a lower wall motion score index (p < 0.005), less pronounced inflammatory response (lower serum levels of IL-6, p < 0.01, and MCP-1, p < 0.05), higher ejection fraction six months after MI (72% vs. 64%, p < 0.05). None of the aborted MI patients died during the 3-year follow-up, while there were 13 deaths among patients with non-aborted MI.Conclusions. The abortion of myocardial infarction results in a better outcome and more favorable prognosis. An inflammatory response is less pronounced in the aborted MI.


O’Gara PT, Kushner FG, Ascheim DD, Casey DE, Chung MK, De Lemos J, et al. ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction: Executive Summary: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 2013;127:529–55.

Van de Werf F, Bax J, Betriu A, Blomstrom-Lundqvist C, Crea F, Falk V Filippatos G, et al. Management of acute myocardial infarction in patients presenting with persistent ST-segment elevation: the Task Force on the Management of ST-Segment Elevation Acute Myocardial Infarction of the European Society of Cardiology. Eur Heart J. 2008;29:2909–45.

Taher T, Fu Y, Wagner GS, Goodman SG, Fresco C, Granger CB, et al. Aborted myocardial infarction in patients with ST-segment elevationInsights from the assessment of the safety and efficacy of a new thrombolytic regimen-3 trial electrocardiographic substudy. J Am Coll Cardiol. 2004;44:38–44.

Weaver W, Hallstrom AP, Litwin PE, Martin JS, Kudenchuk PJ, Eisenberg M. Prehospital-initiated vs hospital-initiated thrombolytic therapy: The myocardial infarction triage and intervention trial. J Am Med Assoc. 1993;270:1211–16.

Lamfers EJP, Hooghoudt TEH, Uppelschoten A, Stolwijk PWJ, Verheugt FWA. Effect of prehospital thrombolysis on aborting acute myocardial infarction. Am J Cardiol. 1999; 84: 928–30.

Hassan AK, Jukema JW, Van der Laarse A, Hasan-Ali H, Wolterbeek R, Van der Kley F, et al. Incidence, patient characteristics and predictors of aborted myocardial infarction in patients undergoing primary PCI: prospective study comparing pre- and in-hospital abciximab pretreatment. EuroIntervention. 2009;4:662–68.

Antman EM, Cooper HA, Gibson CM, De Lemos JA, McCabe CH, Giugliano RP, et al. Determinants of improvement in epicardial flow and myocardial perfusion for ST elevation myocardial infarction. Insights from TIMI 14 and InTIME-II. Eur Heart J. 2002;23:928–33.

Schröder R, Dissmann R, Brüggemann T, Wegscheider K, Linderer T, Tebbe U, et al. Extent of early ST segment elevation resolution: A simple but strong predictor of outcome in patients with acute myocardial infarction. J Am Coll Cardiol. 1994;24:384–91.

Gibson CM, Cannon CP, Daley WL, Dodge JT, Alexander B, Marble SJ McCabe CH, et al. TIMI Frame Count . Circulation. 1996; 93:879–88.

Morrow DA, Antman EM, Charlesworth A, Cairns R, Murphy SA, De Lemos JA, et al. TIMI Risk Score for ST-Elevation Myocardial Infarction: A Convenient, Bedside, Clinical Score for Risk Assessment at Presentation. Circulation. 2000;102:2031–37.

Sciagra R, Parodi G, Sotgia B, Antoniucci D, Pupi A. Determinants of final infarct size and incidence of aborted infarction in patients treated with primary coronary intervention and adjunctive abciximab therapy. Nuklearmed. 2008;47:139–45.

Vasile VC, Babuin L, Ting HH, Bell MR, Orme NM, Yuan BY, et al. Aborted myocardial infarction: Is it real in the troponin era? Am Heart J. 2009;157:636–41.

Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, White HD, et al. Third universal definition of myocardial infarction. Eur Heart J. 2012;33:2551–67.

De Luca G, Suryapranata H, Ottervanger JP, Antman EM. Time Delay to Treatment and Mortality in Primary Angioplasty for Acute Myocardial Infarction . Circulation. 2004;109:1223–25.

De Luca G, Ernst N, Zijlstra F, van’t Hof AWJ, Hoorntje JCA, Dambrink J-HE, et al. Preprocedural TIMI flow and mortality in patients with acute myocardial infarction treated by primary angioplasty. J Am Coll Cardiol. 2004;43:1363–67.

Araszkiewicz A, Lesiak M, Grajek S, Mularek-Kubzdela T, Cieśliński A. Wartość prognostyczna oceny przepływu metodą corrected TIMI Frame Count u chorych z przepływem TIMI 3 w tętnicy odpowiedzialnej za zawał po skutecznej pierwotnej interwencji wieńcowej Predictive value of corrected TIMI Frame Count in patients with TIMI 3. Folia Cardiol. 2004;12:895–902.

Hamada S, Nishiue T, Nakamura S, Sugiura T, Kamihata H, Miyoshi H, et al. TIMI frame count immediately after primary coronary angioplasty as a predictor of functional recovery in patients with TIMI 3 reperfused acute myocardial infarction. J Am Coll Cardiol. 2001;38:666–71.

Edep ME, Guarneri EM, Teirstein PS, Phillips PS, Brown DL. Differences in TIMI frame count following successful reperfusion with stenting or percutaneous transluminal coronary angioplasty for Acute Myocardial Infarction. Am J Cardiol. 1999;83:1326–29.

Eitel I, Desch S, Schindler K, Fuernau G, Schuler G, Thiele H. Aborted myocardial infarction in intracoronary compared with standard intravenous abciximab administration in patients undergoing primary percutaneous coronary intervention for ST-elevation myocardial infarction. Int J Cardiol. 2011;153:21–25.

Ohtsuka T, Hamada M, Inoue K, Ohshima K, Suzuki J, Matsunaka T, et al. Relation of Circulating Interleukin-6 to Left Ventricular Remodeling in Patients with Reperfused Anterior Myocardial Infarction. Clin Cardiol. 2004; 27:417–20.

Frangogiannis NG, Smith CW, Entman ML. The inflammatory response in myocardial infarction. Cardiovasc Res. 2002;53:31–47.

Lindahl B, Toss H, Siegbahn A, Venge P, Wallentin L. Markers of Myocardial Damage and Inflammation in Relation to Long-Term Mortality in Unstable Coronary Artery Disease. New Engl J Med. 2000;343,1139–47.

Kanda T, Inoue M, Kotajima N, Fujimaki S, Hoshino Y, Kurabayashi M, et al. Circulating Interleukin-6 and Interleukin-6 Receptors in Patients with Acute and Recent Myocardial Infarction. Cardiology. 2000;93:191–96.

De Lemos JA, Morrow DA, Sabatine MS, Murphy SA, Gibson CM, Antman EM, et al. Association Between Plasma Levels of Monocyte Chemoattractant Protein-1 and Long-Term Clinical Outcomes in Patients With Acute Coronary Syndromes . Circulation. 2003;107:690–95.

Halkin A, Stone GW, Dixon SR, Grines CL, Tcheng JE, Cox DA, et al. Impact and Determinants of Left Ventricular Function in Patients Undergoing Primary Percutaneous Coronary Intervention in Acute Myocardial Infarction. Am J Cardiol. 2005;96:325–31.

St John Sutton M, Pfeffer MA, Plappert T, Rouleau JL, Moyé LA, Dagenais GR, et al. Quantitative two-dimensional echocardiographic measurements are major predictors of adverse cardiovascular events after acute myocardial infarction. The protective effects of captopril. . Circulation. 1994;89:68–75.

Otterstad JE, St. John Sutton M, Froland G, Skjarpe T, Graving B, Holmes I. Are Changes in Left Ventricular Volume as Measured with the Biplane Simpson’s Method Predominantly Related to Changes in its Area or Long Axis in the Prognostic Evaluation of Remodelling Following a Myocardial Infarction? Eur J Echocardiogr. 2001;2:118–25.

Eitel I, Desch S, Sareban M, Fuernau G, Gutberlet M, Schuler G, et al. Prognostic significance and magnetic resonance imaging findings in aborted myocardial infarction after primary angioplasty. Am Heart J. 2009;158:806–13.

Wu E, Judd RM, Vargas JD, Klocke FJ, Bonow RO, Kim RJ. Visualisation of presence, location, and transmural extent of healed Q-wave and non Q-wave myocardial infarction. Lancet. 2001;357:21–28.

Surber R, Schwarz G, Figulla HR, Werner GS. Resting 12-lead electrocardiogram as a reliable predictor of functional recovery after recanalization of chronic total coronary occlusions. Clin Cardiol. 2005;28:293–97.

How to Cite
Pyda, M., Grajek, S., Oleśkowska-Florek, W., Lesiak, M., Siniawski, A., Gwizdała, A., Grygier, M., & Araszkiewicz, A. (2016). Aborted myocardial infarction in patients undergoing primary percutaneous coronary intervention. Journal of Medical Science, 84(1), 27-33. Retrieved from http://jms.ump.edu.pl/index.php/JMS/article/view/32
Original Papers