TY  - BOOK
AU  - Dvir, Danny
TI  - The impact of intracoronary thrombus aspiration on STEMI outcomes
SN  - 1878-0938
KW  - *Angioplasty, Balloon, Coronary
KW  - *Coronary Thrombosis/th [Therapy]
KW  - *Myocardial Infarction/th [Therapy]
KW  - *Thrombectomy
KW  - Aged
KW  - Angioplasty, Balloon, Coronary/ae [Adverse Effects]
KW  - Angioplasty, Balloon, Coronary/mo [Mortality]
KW  - Cardiovascular Diseases/et [Etiology]
KW  - Chi-Square Distribution
KW  - Coronary Angiography
KW  - Coronary Thrombosis/co [Complications]
KW  - Coronary Thrombosis/mo [Mortality]
KW  - Coronary Thrombosis/ra [Radiography]
KW  - Female
KW  - Humans
KW  - Israel
KW  - Male
KW  - Middle Aged
KW  - Myocardial Infarction/et [Etiology]
KW  - Myocardial Infarction/mo [Mortality]
KW  - Myocardial Infarction/ra [Radiography]
KW  - Propensity Score
KW  - Registries
KW  - Retrospective Studies
KW  - Risk Assessment
KW  - Risk Factors
KW  - Suction
KW  - Thrombectomy/ae [Adverse Effects]
KW  - Thrombectomy/mo [Mortality]
KW  - Thrombectomy/mt [Methods]
KW  - Time Factors
KW  - Treatment Outcome
KW  - MedStar Heart & Vascular Institute
KW  - Journal Article
N1  - Available in print through MWHC library: 2002 - present
N2  - 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
UR  - http://dx.doi.org/10.1016/j.carrev.2012.01.005
ER  -