Thrombus aspiration in ST elevation myocardial infarction: comparative efficacy in patients treated early and late after onset of symptoms.

Francesco Burzotta, Carlo Trani, Filippo Crea, Maria De Vita, Italo Porto, Giampaolo Niccoli, Giuseppe Biondi Zoccai, Darius Dudek, Thierry Lefevre, Waldermar Mielecki

Risultato della ricerca: Contributo in rivistaArticolo in rivista

26 Citazioni (Scopus)

Abstract

BACKGROUND: Restoration of myocardial perfusion is the goal of percutaneous coronary intervention (PCI) in patients with ST elevation myocardial infarction. A major predictor of no-reflow is the increasing time to treatment (TTT). Thrombus aspiration (TA) is reported to improve myocardial reperfusion as compared with standard PCI (SP). OBJECTIVE: To investigate the influence of TTT on TA efficacy. DESIGN: Pooled analysis of individual patients' data of three prospective randomised trials comparing TA and SP. PATIENTS: A total of 299 patients (150 in TA group and 149 in SP group) entered the study. The study population was divided into three subgroups according to the TTT: < or = 3 h (short TTT subgroup), >3 h to < or = 6 h (intermediate TTT subgroup), >6 h to < or = 12 h (long TTT subgroup). MAIN OUTCOME MEASURES: The goal of the study was the comparison of optimal myocardial reperfusion, defined as the combination of myocardial blush grade 2 or 3 at post-PCI angiography and ST resolution more than 70% at post-PCI ECG, between SP and TA according to TTT. RESULTS: In the SP group, increasing TTT was associated with a decreased rate of optimal reperfusion (27.4% vs 17.9% vs 10%, p for trend=0.06), whereas in the TA group the same trend was not seen (40.9% vs 33.8% vs 50%, p for trend=0.93). In a multivariate logistic regression model, a significant interaction (p=0.04) between time to treatment and thrombus aspiration was observed. CONCLUSIONS: TA limits the adverse effects of TTT prolongation on myocardial reperfusion.
Lingua originaleEnglish
pagine (da-a)1287-1290
Numero di pagine4
RivistaHeart
Stato di pubblicazionePubblicato - 2010

Keywords

  • myocardial infarction
  • PCI

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