Comparison of myocardial microcirculatory perfusion after catheter‐administered intracoronary thrombolysis with anisodamine versus standard thrombus aspiration in patients with ST‐elevation myocardial infarction

Autor: Yong‐Jun Li, Qing-Min Wei, Yunfa Jiang, Weize Fan, Yanming Fan, Guozhen Hao, Yang Fu, Xianghua Fu, Xinshun Gu
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
Cardiac Catheterization
Time Factors
percutaneous aspiration thrombectomy
medicine.medical_treatment
Coronary Artery Disease
pro‐urokinase
030204 cardiovascular system & hematology
Solanaceous Alkaloids
Original Studies
chemistry.chemical_compound
0302 clinical medicine
Risk Factors
Thrombolytic Therapy
030212 general & internal medicine
Myocardial infarction
Prospective Studies
Stroke
Thrombectomy
General Medicine
Middle Aged
Thrombosis
surgical procedures
operative
Treatment Outcome
Cardiology
anisodamine
Female
Cardiology and Cardiovascular Medicine
TIMI
medicine.medical_specialty
China
Anisodamine
03 medical and health sciences
Percutaneous Coronary Intervention
Fibrinolytic Agents
Internal medicine
Coronary Circulation
medicine
Humans
Radiology
Nuclear Medicine and imaging
cardiovascular diseases
Thrombus
Vascular Patency
Aged
business.industry
Coronary Thrombosis
Microcirculation
Percutaneous coronary intervention
ST‐elevation myocardial infarction
medicine.disease
Urokinase-Type Plasminogen Activator
chemistry
Conventional PCI
Feasibility Studies
ST Elevation Myocardial Infarction
business
Zdroj: Catheterization and Cardiovascular Interventions
ISSN: 1522-726X
1522-1946
Popis: Objective To evaluate efficacy, safety and feasibility of targeted intracoronary injection using pro-urokinase combined with anisodamine (TCA) versus thrombus aspiration (TA) in ST-elevation myocardial infarction (STEMI) patients with high thrombus loads. Background The best method of avoiding thrombus detachment and stroke in PCI patients with high thrombus loads has not yet been established. Methods STEMI patients receiving coronary artery angiography or percutaneous coronary intervention (CAG/PCI) with thrombus grade ≥ 3 from January 1, 2017 to June 30, 2018 were randomly assigned to targeted intracoronary thrombolysis (pro-urokinase and anisodamine via catheter (TCA) group), or the TA group which followed the standard thrombus aspiration procedure. Parameters compared included thrombus grade, index of microcirculatory resistance (IMR), postoperative myocardial SPECT, thrombosis in myocardial infarction (TIMI) scores including flow grade, corrected TIMI frame counts (CTFCs), and TIMI myocardial perfusion grade (TMPG). Adverse events were followed up within 3 months. Results Thirty-nine patients were finally enrolled. In primary CAG/PCI, the TCA group had higher percentages of TIMI 3 flow and lower IMR values compared with the TA group. The ratio of TMPG 3 grade in the TCA group was higher in repeat CAG, and the perfusion descending area (PDA) presented by SPECT was lower than in the TA group. No significant difference was seen in major adverse coronary events (MACEs) or bleeding events at follow-up. Conclusions TCA appears to be effective, safe, and feasible for repatency and reduction of high thrombus burden in primary PCI and may protect myocardial microcirculation with improved outcomes.
Databáze: OpenAIRE
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