Document Detail


Synergistic effect of thrombus aspiration and abciximab in primary percutaneous coronary intervention.
MedLine Citation:
PMID:  23359568     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND.: Previous studies failed to assess the individual prognostic role of thrombus aspiration (TA) or abciximab in primary percutaneous coronary intervention (pPCI), due their prevalent combined use. METHODS AND RESULTS.: A total of 644 consecutive STEMI patients treated with pPCI were included in this retrospective registry from January 2006 to December 2008. Patients were divided in: a) Group 1, with conventional pPCI; b) Group 2, with pPCI and abciximab; c) Group 3, with pPCI and TA; d) Group 4, with pPCI and abciximab plus TA. Primary end point was the composite of major adverse cardiovascular events (MACE, defined as overall mortality, myocardial infarction, target vessel revascularization, and major bleedings) at one year. Baseline clinical and angiographic characteristics were not different among the groups, with the exception of a younger age in group 4. The 2 groups of patients treated with thrombus aspiration (group 3 and 4) received more frequently direct stenting (p<0.001 vs. group 1 for both), presented higher rate of end-procedural TIMI flow grade 3 (p<0.001 vs. group 1 for both), and lower rate of no-reflow (p=0.016 and p<0.001 vs. group 1, respectively). Patients of group 2 presented a borderline non-significant trend toward higher rate of end-procedural TIMI flow grade 3 (p=0.083 vs. group 1). MACEs at one year were 43 (29%) in group 1 vs. 25 (22%) in group 2 vs. 24 (19%) in group 3 vs. 32 (13%) in group 4 (log-rank p=0.001). At the multivariate Cox regression analysis, combined TA plus abciximab in group 4 (HR: 0.48, CI 95% 0.28-0.84, p=0.01) and a higher left ventricular ejection fraction (HR: 0.97, CI 95% 0.95-0.98, p<0.001) were significantly associated with lower MACE rate. CONCLUSIONS.: The combination of pharmacologic and mechanic antithrombotic treatment during pPCI was associated with better 1-year clinical outcome. © 2013 Wiley Periodicals, Inc.
Authors:
Stylianos A Pyxaras; Fabio Mangiacapra; Katia Verhamme; Luigi Di Serafino; Frederic De Vroey; Gabor Toth; Andrea Perkan; Alessandro Salvi; Jozef Bartunek; Bernard De Bruyne; William Wijns; Gianfranco Sinagra; Emanuele Barbato
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-29
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  -     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 Wiley Periodicals, Inc.
Affiliation:
Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium; Cardiovascular Department, University Hospital of Trieste, Trieste, Italy.
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