Circadian dependence of manual thrombus aspiration benefit in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention

Autor: Stéphane Cook, Sophie Degrauwe, Rachel Fesselet, Marco Roffi, Pier Giorgio Masci, Umberto Benedetto, Eric Eeckhout, Paul Erne, Dragana Radovanovic, Andrea Zuffi, Franz R. Eberli, Stéphane Noble, Stephane Fournier, Juan F. Iglesias, Thomas Pilgrim, Hans Rickli, Olivier Muller, Stephan Windecker
Přispěvatelé: University of Zurich, Iglesias, Juan F
Rok vydání: 2017
Předmět:
Male
Time Factors
medicine.medical_treatment
030204 cardiovascular system & hematology
0302 clinical medicine
Risk Factors
Clinical endpoint
ST segment
Hospital Mortality
Registries
030212 general & internal medicine
Myocardial infarction
610 Medicine & health
Thrombectomy
biology
Incidence
Primary percutaneous coronary intervention
General Medicine
Middle Aged
Circadian Rhythm
Treatment Outcome
Cardiology
Female
Cardiology and Cardiovascular Medicine
Switzerland
medicine.medical_specialty
Myocardial Reperfusion Injury
2705 Cardiology and Cardiovascular Medicine
Myocardial infarct size
03 medical and health sciences
Percutaneous Coronary Intervention
Internal medicine
medicine
Humans
Circadian rhythms
Circadian rhythm
Propensity Score
Aged
Retrospective Studies
Chi-Square Distribution
business.industry
Percutaneous coronary intervention
Retrospective cohort study
10060 Epidemiology
Biostatistics and Prevention Institute (EBPI)
medicine.disease
biology.protein
Manual thrombus aspiration
ST Elevation Myocardial Infarction
Creatine kinase
business
Chi-squared distribution
Zdroj: Fournier, S, Muller, O, Benedetto, U, Roffi, M, Pilgrim, T, Eberli, F R, Rickli, H, Radovanovic, D, Erne, P, Cook, S, Noble, S, Fesselet, R, Zuffi, A, Degrauwe, S, Masci, P G, Windecker, S, Eeckhout, E, Iglesias, J F 2018, ' Circadian dependence of manual thrombus aspiration benefit in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention ', Clinical Research in Cardiology, vol. 107, no. 4, pp. 338-346 . https://doi.org/10.1007/s00392-017-1189-8
Fournier, Stephane; Muller, Olivier; Benedetto, Umberto; Roffi, Marco; Pilgrim, Thomas; Eberli, Franz R; Rickli, Hans; Radovanovic, Dragana; Erne, Paul; Cook, Stéphane; Noble, Stéphane; Fesselet, Rachel; Zuffi, Andrea; Degrauwe, Sophie; Masci, PierGiorgio; Windecker, Stephan; Eeckhout, Eric; Iglesias, Juan F (2018). Circadian dependence of manual thrombus aspiration benefit in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Clinical research in cardiology, 107(4), pp. 338-346. Springer-Medizin-Verlag 10.1007/s00392-017-1189-8
ISSN: 1861-0692
1861-0684
DOI: 10.1007/s00392-017-1189-8
Popis: Background: The clinical benefit of manual thrombus aspiration (TA) during primary percutaneous coronary intervention (PPCI) in patients with ST-segment elevation myocardial infarction (STEMI) remains uncertain. This study assessed the impact of circadian rhythms on the effectiveness of manual TA. Methods and results: We conducted an observational study of patients enrolled in the Acute Myocardial Infarction in Switzerland Plus registry. STEMI patients undergoing PPCI with (TA group) or without (PCI-alone group) manual TA were divided based on time-of-day symptom onset: group 1 (00:00–05:59), group 2 (06:00–11:59), group 3 (12:00–17:59) and group 4 (18:00–23:59). The primary endpoint was circadian variation of myocardial infarction (MI) size. The secondary endpoint was in-hospital all-cause mortality. Between 2009 and 2014, 3648 patients underwent PPCI (TA, 49%). After propensity-score matching, 2860 patients were included. Minimal myocardial Injury was observed in groups 2 and 3 (peak creatine kinase level group 1, 2723 ± 148 U/l; group 2, 2493 ± 105 U/l; group 3, 2550 ± 106 U/l; group 4, 2952 ± 144 U/l; p = 0.044) in the TA group, whereas no time-of-day dependence was found in PCI-alone group. After periodic sinusoidal regression analysis, a circadian relationship between time-of-day symptom onset and MI size was demonstrated in the TA group (p < 0.001). In-hospital all-cause mortality was 3.4% in the TA group and 4.3% in the PCI-alone group (p = 0.20). Conclusions: In this large registry of STEMI patients, manual TA did not reduce in-hospital all-cause mortality. Nonetheless, there was a circadian dependence of TA effectiveness with greatest myocardial salvage for patients with symptom onset between 06:00 and 17:59.
Databáze: OpenAIRE
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