Ibrahim and Aziz. Int J Clin Cardiol 2019, 6:149 Volume 6 | Issue 3 DOI: 10.23937/2378-2951/1410149 Open Access ISSN: 2378-2951 International Journal of Clinical Cardiology • Page 1 of 6 • Citaton: Ibrahim IM, Aziz MA (2019) Impact of Low-Dose Intracoronary Alteplase Infusion afer Suc- cessful Primary Percutaneous Coronary Interventon. Int J Clin Cardiol 6:149. doi.org/10.23937/2378- 2951/1410149 Accepted: June 03, 2019; Published: June 05, 2019 Copyright: © 2019 Ibrahim IM, et al. This is an open-access artcle distributed under the terms of the Creatve Commons Atributon License, which permits unrestricted use, distributon, and reproducton in any medium, provided the original author and source are credited. Ibrahim and Aziz. Int J Clin Cardiol 2019, 6:149 Impact of Low-Dose Intracoronary Alteplase Infusion afer Successful Primary Percutaneous Coronary Interventon Ismail Mohamed Ibrahim * and Mahmoud Abdel Aziz Department of Cardiology, Zagazig University, Zagazig, Egypt *Corresponding author: Ismail Mohamed Ibrahim, Department of Cardiology, Zagazig University, Zagazig, Egypt, Tel: +201145262020 Abstract Background and aim: In ST elevation myocardial infarc- tion (STEMI), intracoronary thrombolysis after primary per- cutaneous coronary intervention (PPCI) was found to im- prove microvascular perfusion, yet without improvement in left ventricular (LV) remodeling. Our study aimed to fnd out possible effect on LV longitudinal function. Methods and results: 102 anterior STEMI patients eligi- ble for PPCI were divided into: Alteplase group (53 patients; received intracoronary 0.3 mg/kg alteplase after PPCI) and control group (49 patients; treated with PPCI only). LV longi- tudinal function was assessed using tissue Doppler imaging (to measure mean S' and maximum Q-S' time difference) and speckle tracking (to measure global longitudinal strain (GLS)) 48 hours and 6 months after PPCI. In alteplase group, epicardial (p value < 0.001 for corrected TIMI frame count) and myocardial perfusion (p value for myocardial blush grade 0.03) were signifcantly higher. GLS and LV synchrony were better in alteplase group both at 48 hours (p value 0.02 and < 0.001 respectively) and at 6 months (p value < 0.001 for each). No difference in bleeding rates was noted between groups. Conclusion: Adjunctive low-dose alteplase infusion after PPCI improves microvascular perfusion and LV longitudinal function without increasing bleeding risk. ReseARch ARtIcle [2] and LV functon [3-7]. In additon to the metabolic derangement of reperfusion injury [8,9], both proximal embolizaton [10,11] and microvascular in-situ throm- bosis [12] play role in microvascular damage. The use of intra-coronary thrombolysis (e.g. Al- teplase) immediately afer PPCI was tested and showed improved epicardial and microvascular coronary fow [12-14]. Recently, global longitudinal strain (GLS) has emerged as a readily accessible and reproducible tool for estmaton of microvascular damage [15] and f- nal infarct size [16] comparable to the gold standard cardiac magnetc resonance (CMR). To the best of our knowledge, we are the frst to study the acute and in- termediate term efects of intra-coronary alteplase on GLS. Patents and Methods We included 106 consecutve STEMI patents eligi- ble for PPCI. They were divided into 2 groups: Alteplase group (53 patents who received intracoronary alteplase afer successful PPCI) and control group (53 patents who were treated with successful PPCI only). All patents were given the necessary informaton about the study. Zagazig University, Faculty of Medicine ethics commitee approved our study, and writen informed consent was obtained from all patents. Inclusion criteria - First anterior wall STEMI suitable for PPCI of the infarct related artery (IRA). Check for updates Introducton The corner stone in ST elevaton myocardial in- farcton (STEMI) management is tmely and successful recanalizaton of infarct related artery (IRA) using pri- mary percutaneous coronary interventon (PPCI) [1]. However, this may be hampered by the occurrence of tssue-level non-perfusion termed microvascular oc- clusion (MVO) which adversely afects fnal infarct size