| Effect of Macroscopic-Positive Thrombus Retrieval During Primary Percutaneous Coronary Intervention With Thrombus Aspiration on Myocardial Infarct Size and Microvascular Obstruction. | |
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MedLine Citation:
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PMID: 23102881 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Adjunctive thrombus aspiration (TA) during primary percutaneous coronary intervention improves myocardial perfusion and survival; however, the effect of effective thrombus retrieval remains unclear. We evaluated whether macroscopic-positive TA in patients with ST-segment elevation myocardial infarction would reduce the infarct size (IS) and microvascular obstruction (MVO), as assessed by contrast-enhanced magnetic resonance imaging. A total of 88 patients with ST-segment elevation myocardial infarction were prospectively recruited and assigned to the TA-positive group (n = 38) or TA-negative group (n = 50) according to whether macroscopic aspirate thrombus was visible to the naked eye. The primary end points were the extent of early and late MVO as assessed by contrast-enhanced magnetic resonance imaging performed during in-hospital stay and IS evaluated in the acute phase and at 6 months of follow-up. The incidence of early and late MVO and IS in the acute phase was lower in the TA-positive group than in the TA-negative group (early MVO 3.8 ± 1.1% vs 7.6 ± 2.1%, respectively, p = 0.003; late MVO 2.1 ± 0.9% vs 5.4 ± 2.9%, p = 0.006; and IS 14.9 ± 8.7% vs 28.2 ± 15.8%, p = 0.004). At the 6-month contrast-enhanced magnetic resonance imaging study, the final IS was significantly lower in the TA-positive group (12.0 ± 8.3% vs 22.3 ± 14.3%, respectively) than in the TA-negative group (p = 0.002). After multivariate adjustment, macroscopic-positive TA represented an independent predictor of final IS (odds ratio 0.34, 95% confidence interval 0.03 to 0.71, p = 0.01). In conclusion, effective macroscopic thrombus retrieval before stenting during percutaneous coronary intervention for ST-segment elevation myocardial infarction is associated with an improvement in myocardial reperfusion, as documented by a clear reduction in the MVO extent and IS. |
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Authors:
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Romain Chopard; Philoktimon Plastaras; Jerome Jehl; Sebastien Janin; Vincent Descotes Genon; Marie-France Seronde; Siamak Davani; Bruno Kastler; Francois Schiele; Nicolas Meneveau |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-10-24 |
Journal Detail:
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Title: The American journal of cardiology Volume: - ISSN: 1879-1913 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2012 Oct |
Date Detail:
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Created Date: 2012-10-29 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Cardiology, University Hospital Jean Minjoz, University of Franche-Comte, Besançon, France. Electronic address: rchopard@chu-besancon.fr. |
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