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To the Editor: Dr Valgimigli and colleagues¹ evaluated the clinical and angiographic effects of single high-dose bolus tirofiban plus sirolimus-eluting stenting vs abciximab plus bare-metal stenting. In this study, a baseline Thrombolysis in Myocardial Infarction grade of 0 to 1 was present in more than 70% of patients. A postprocedure grade 3 was achieved in more than 90% of patients, but the myocardial blush grade after reperfusion, one of the most important angiographic indices of myocardial reperfusion and predictors of left ventricular recovery,² was not mentioned. Also, the authors did not specify if any intracoronary thrombectomy device, balloon predilatation, or intracoronary vasodilators were used.

This information is important because the benefit of angioplasty in patients with STEMI is limited by the no-reflow phenomenon that can occur, particularly when complex thrombotic lesions are present. In the setting of STEMI, thrombectomy devices may allow removal of soft material immediately before stenting to . . . [Full Text of this Article]

Leonardo De Luca, MD
leo.deluca@libero.it

Gennaro Sardella, MD
Department of Cardiovascular and Respiratory Sciences
Policlinico Umberto I
La Sapienza University
Rome, Italy

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