| Distal protection device protects microvascular integrity during primary percutaneous intervention in acute myocardial infarction: a prospective, randomized, multicenter trial. | |
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MedLine Citation:
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PMID: 17490759 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Distal protection during primary angioplasty in acute myocardial infarction (AMI) is the subject of recent controversy. The present study was designed to determine whether the distal embolic protection preserves myocardial microvascular integrity and improves clinical outcomes in patients with AMI. METHODS: A total of 116 AMI patients presenting within 12 h of onset of symptoms were enrolled at 7 angioplasty centers. They were randomly assigned to either primary angioplasty with distal protection group (DP; n=60) or angioplasty alone group (Controls; n=56). RESULTS: After primary angioplasty, achievement of final Thrombolysis In Myocardial Infarction (TIMI) grade 3 and TIMI Myocardial Perfusion (TMP) grade 3 were more frequent in the DP group than in the control group [58/60 (96%) vs. 43/56 (81%), p=0.016; and 39/60 (65%) vs. 20/56 (38%), p=0.001, respectively]. After primary angioplasty, the baseline and hyperemic averaged peak velocities were significantly higher (23.2+/-11.5 vs. 18.0+/-6.9 cm/s, p=0.029; and 39.2+/-16.7 vs. 30.6+/-10.8 cm/s, p=0.014, respectively) and the baseline and hyperemic microvascular resistance indices were significantly lower (4.18+/-2.22 vs. 5.34+/-2.25 mm Hg cm(-1) s, p=0.036; and 2.38+/-1.39 vs. 3.11+/-1.32 mm Hg cm(-1) s, p=0.030, respectively) in the DP group. Patients in the DP group showed more favorable phasic coronary flow pattern in diastolic deceleration time (679+/-262 vs. 519+/-289 ms, p=0.035; and 751+/-246 vs. 616+/-269 ms, p=0.035, respectively). Major adverse cardiac events at 6 months occurred with similar frequency in both groups (8.7% vs. 11.1%, p=0.400). CONCLUSIONS: Distal protection device effectively preserves microvascular integrity during primary angioplasty in AMI. Distal protection, however, did not improve clinical outcomes. |
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Authors:
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Seung-Jea Tahk; Byoung-Joo Choi; So-Yeon Choi; Myeong-Ho Yoon; Hyeon-Cheol Gwon; Geu-Ru Hong; Young-Jo Kim; Seung-Ho Hur; Kwon-Bae Kim; Bon-Kwon Koo; Seung-Hwan Lee; Junghan Yoon |
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Publication Detail:
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Type: Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2007-05-08 |
Journal Detail:
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Title: International journal of cardiology Volume: 123 ISSN: 1874-1754 ISO Abbreviation: Int. J. Cardiol. Publication Date: 2008 Jan |
Date Detail:
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Created Date: 2007-12-18 Completed Date: 2008-01-29 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8200291 Medline TA: Int J Cardiol Country: Netherlands |
Other Details:
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Languages: eng Pagination: 162-8 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Ajou University School of Medicine, San 5 Wonchun-dong, Yeongtong-gu, Suwon, 443-721, Republic of Korea. sjtahk@ajou.ac.kr |
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| MeSH Terms | |
Descriptor/Qualifier:
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Angioplasty, Transluminal, Percutaneous Coronary*
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adverse effects Balloon Occlusion / instrumentation* Embolism / etiology, prevention & control* Female Humans Male Microcirculation Middle Aged Myocardial Infarction / therapy* Prospective Studies |
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