Clinical effectiveness of thrombus aspiration during percutaneous coronary intervention for stent thrombosis in a contemporary setting.

Autor:	Konstantinou K; Department of Cardiology, Essex Cardiothoracic Centre, Basildon, United Kingdom; School of Medicine, Anglia Ruskin University, Chelmsford, United Kingdom., Davies JR; Department of Cardiology, Essex Cardiothoracic Centre, Basildon, United Kingdom; School of Medicine, Anglia Ruskin University, Chelmsford, United Kingdom., Alsanjari O; Department of Cardiology, Essex Cardiothoracic Centre, Basildon, United Kingdom; School of Medicine, Anglia Ruskin University, Chelmsford, United Kingdom., Kelly PA; Department of Cardiology, Essex Cardiothoracic Centre, Basildon, United Kingdom., Tang KH; Department of Cardiology, Essex Cardiothoracic Centre, Basildon, United Kingdom., Kassimis G; Department of Cardiology, Essex Cardiothoracic Centre, Basildon, United Kingdom; 2(nd) Cardiology Department Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece., Alexopoulos D; Department of Cardiology, Essex Cardiothoracic Centre, Basildon, United Kingdom; 2(nd) Cardiology Department University of Athens, ATTIKON University Hospital, Athens, Greece., Clesham GJ; Department of Cardiology, Essex Cardiothoracic Centre, Basildon, United Kingdom; School of Medicine, Anglia Ruskin University, Chelmsford, United Kingdom., Keeble TR; Department of Cardiology, Essex Cardiothoracic Centre, Basildon, United Kingdom; School of Medicine, Anglia Ruskin University, Chelmsford, United Kingdom., Karamasis GV; Department of Cardiology, Essex Cardiothoracic Centre, Basildon, United Kingdom; School of Medicine, Anglia Ruskin University, Chelmsford, United Kingdom; 2(nd) Cardiology Department University of Athens, ATTIKON University Hospital, Athens, Greece. Electronic address: grigoris.karamasis@gmail.com.
Jazyk:	angličtina
Zdroj:	Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese [Hellenic J Cardiol] 2022 Jul-Aug; Vol. 66, pp. 11-18. Date of Electronic Publication: 2022 Mar 16.
DOI:	10.1016/j.hjc.2022.03.004
Abstrakt:	Objective: The impact of adjunctive manual thrombus aspiration (TA) in patients with stent thrombosis (ST) treated with percutaneous intervention has not been evaluated in the current era of potent P2Y12 agents and new-generation drug-eluting stents. We sought to assess the effect of TA using data from a large contemporary registry. Methods: The study population was derived from the Essex ST Investigation Registry (ESTHIR), which contains all consecutive cases of angiographically determined definite ST undergoing interventional treatment in a tertiary cardiac centre between November 2015 and June 2018. Propensity score matching was performed to match patients who underwent TA (TA group) to those who did not (n-TA group). The study endpoints were final TIMI flow and survival free of cardiovascular death (CD) or target lesion revascularisation (TLR). Results: A total of 128 ST patients were included in the present analysis. The mean age was 65 ± 11 years, and 84% were male. About 90% of the patients presented with STEMI, and 85% had very late ST. Seventy-two patients (56%) underwent TA. After propensity score matching, 30 patients were included in each study group. A higher rate of final TIMI III flow was observed in the TA group (TA vs n-TA group, 100% vs 83%), but this difference did not reach statistical significance (p = 0.052). At 1000 days of follow-up, survival free of CD or TLR was not different between the two groups (p = 0.8). Conclusion: In a propensity-matched population of ST patients undergoing PCI in a contemporary setting, TA was not associated with improved final TIMI flow or long-term cardiovascular outcomes. (Copyright © 2022 Hellenic Society of Cardiology. Published by Elsevier B.V. All rights reserved.)
Databáze:	MEDLINE
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