Background: Distal embolization of the thrombus and plaque debris, as well as the release of inflammatory and vasoactive factors are suggested as important factors that may jeopardize successful myocardial reperfusion during primary coronary intervention. Methods: We performed in 18 acute myocardial infaction patients primary percutaneous coronary intervention (PCI) with the distal protection device of distal occlusive balloon type, PercuSurge GuideWire system. We collected blood samples from culprit coronary artery using Export aspiration catheter after predilation while inflating the distal protection balloon and then after completing PCI with deflation of the distal protection balloon. We determined concentrations of C-reactive protein, soluble CD40 ligand, IL-6, serotonin, tissue factor, and factor VIIa in the aspirated blood samples from the culprit coronary artery of patients with acute myocardial infarction undergoing primary coronary intervention and compared them with those in peripheral blood before PCI. Results: The concentrations of soluble CD40 ligand (2.84±3.74 vs 0.98±0.63 ng/mL, p=0.004), IL-6 (33.67±32.63 vs 17.08±21.41 ng/mL, p<0.001), serotonin (2.05±0.76 vs 0.92±0.60 ng/mL, p<0.001), tissue factor (257.17±84.34 vs 154.60±87.99 ng/mL, p<0.001) and factor VIIa (34.30±27.30 vs 24.19±28.00 ng/mL, p=0.016) were significantly higher in the culprit coronary artery than those in peripheral blood. However, the CRP concentrations in the samples from the culprit coronary artery and the femoral artery did not differ significantly (4.15±3.19 vs 4.60±3.68 ng/mL, p=0.056). The aspiration of blood from culprit lesion during PCI with the protection device reduced the concentrations of soluble CD40 ligand, IL-6, serotonin, tissue factor and factor VIIa in the culprit artery. Conclusions: We found increased levels of soluble inflammatory and vasoacyive factors such as soluble CD40 ligand, IL-6, serotonin, tissue factor and factor VII in the aspirate from the culprit coronary artery compared to those in peripheral blood. The aspiration of blood from culprit lesion during PCI reduced significantly the concentrations of inflammatory and vasoactive markers.
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