The impact of intracoronary thrombus aspiration on STEMI outcomes.

MedStar author(s):
Citation: Cardiovascular Revascularization Medicine. 13(3):167-71, 2012 May-Jun.PMID: 22475867Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Angioplasty, Balloon, Coronary | *Coronary Thrombosis/th [Therapy] | *Myocardial Infarction/th [Therapy] | *Thrombectomy | Aged | Angioplasty, Balloon, Coronary/ae [Adverse Effects] | Angioplasty, Balloon, Coronary/mo [Mortality] | Cardiovascular Diseases/et [Etiology] | Chi-Square Distribution | Coronary Angiography | Coronary Thrombosis/co [Complications] | Coronary Thrombosis/mo [Mortality] | Coronary Thrombosis/ra [Radiography] | Female | Humans | Israel | Male | Middle Aged | Myocardial Infarction/et [Etiology] | Myocardial Infarction/mo [Mortality] | Myocardial Infarction/ra [Radiography] | Propensity Score | Registries | Retrospective Studies | Risk Assessment | Risk Factors | Suction | Thrombectomy/ae [Adverse Effects] | Thrombectomy/mo [Mortality] | Thrombectomy/mt [Methods] | Time Factors | Treatment OutcomeLocal holdings: Available in print through MWHC library: 2002 - presentISSN:
  • 1878-0938
Name of journal: Cardiovascular revascularization medicine : including molecular interventionsAbstract: BACKGROUND: Manual coronary thrombus aspiration was associated with improved outcomes of ST-elevation myocardial infarction (STEMI) patients. We aimed to evaluate the outcome of aspiration in a "real-world" setting of primary percutaneous coronary intervention (PPCI).CONCLUSIONS: Although this was largely a negative study, when STEMI involved a large jeopardized myocardium, aspiration was associated with sustained improved clinical outcomes. Copyright 2012 Elsevier Inc. All rights reserved.METHODS AND MATERIALS: We analyzed the outcome of STEMI patients who underwent PPCI (initial Thrombolysis in Myocardial Infarction flow grade 0/1), comparing patients who underwent aspiration (ASP) to those who had standard (STD) therapy. Various subgroups outcomes were further analyzed. Clinical end points included mortality and major adverse cardiovascular events (MACE) at 30 days and at 1 year.RESULTS: One thousand thirty-five consecutive patients were included: 189 (18.26%) with ASP and 846 (81.74%) with STD. ASP patients were younger (58+/-12 vs. 61+/-13, P<.05) and had higher incidence of direct stenting compared to STD patients (34% vs. 16.7%, P<.05). No significant differences were noted in the outcome of ASP vs. STD at 30 days (mortality rate 4.2% vs. 4.5%, P=.9; MACE 6.9% vs. 9.8%, P=.2) and at 1 year (mortality rate 8.0% vs. 8.3%, P=.9; MACE 20.0% vs. 22.3%, P=.5). A significant advantage in favor of ASP was evident in patients with proximal culprit lesions, anterior infarcts, and right ventricular involvement.All authors: Assali A, Battler A, Bental T, Brosh D, Dvir D, Kornowski R, Lev E, Minha S, Rechavia E, Shor N, Teplitsky I, Vaknin-Assa HDigital Object Identifier: Date added to catalog: 2013-09-17
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Journal Article MedStar Authors Catalog Article Available 22475867

Available in print through MWHC library: 2002 - present

BACKGROUND: Manual coronary thrombus aspiration was associated with improved outcomes of ST-elevation myocardial infarction (STEMI) patients. We aimed to evaluate the outcome of aspiration in a "real-world" setting of primary percutaneous coronary intervention (PPCI).

CONCLUSIONS: Although this was largely a negative study, when STEMI involved a large jeopardized myocardium, aspiration was associated with sustained improved clinical outcomes. Copyright 2012 Elsevier Inc. All rights reserved.

METHODS AND MATERIALS: We analyzed the outcome of STEMI patients who underwent PPCI (initial Thrombolysis in Myocardial Infarction flow grade 0/1), comparing patients who underwent aspiration (ASP) to those who had standard (STD) therapy. Various subgroups outcomes were further analyzed. Clinical end points included mortality and major adverse cardiovascular events (MACE) at 30 days and at 1 year.

RESULTS: One thousand thirty-five consecutive patients were included: 189 (18.26%) with ASP and 846 (81.74%) with STD. ASP patients were younger (58+/-12 vs. 61+/-13, P<.05) and had higher incidence of direct stenting compared to STD patients (34% vs. 16.7%, P<.05). No significant differences were noted in the outcome of ASP vs. STD at 30 days (mortality rate 4.2% vs. 4.5%, P=.9; MACE 6.9% vs. 9.8%, P=.2) and at 1 year (mortality rate 8.0% vs. 8.3%, P=.9; MACE 20.0% vs. 22.3%, P=.5). A significant advantage in favor of ASP was evident in patients with proximal culprit lesions, anterior infarcts, and right ventricular involvement.

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