Study population
We studied 90 consecutive patients (65 men, age 60 ± 11 years) with a first AMI referred for primary percutaneous coronary intervention (PCI) and presentation <12 h after symptom onset. The definition of AMI was based on the recent consensus document including appropriate rise and fall in cardiac biomarkers [17]. Excluded were patients <18 years and those with contraindications for CMR. The institutional review board of our hospital approved the study, and patients were included after written informed consent was obtained.
Before emergency PCI all patients received 500 mg aspirin, 5,000 U heparin and 600 mg clopidogrel. The culprit coronary artery was the LAD in 31%, the RCA in 56% and LCx in 13% of patients; single vessel disease was present in 52%, two vessel disease in 23% and three vessel disease in 25%. All patients received standard post-PCI care, including dual antiplatelet therapy for at least 1 month. Thrombosuction, which was not standard treatment at the time of this study, and downstream administration of intravenous abciximab, intracoronary nitroglycerine and adenosine were left to the discretion of the interventional cardiologist.