Thrombus Aspiration Before Primary Angioplasty Improves Myocardial Reperfusion in Acute Myocardial Infarction
| Autor: | Paola Colombo, Giacomo Piccalò, Riccardo Bigi, Anabella Delgado, Pedro Silva-Orrego, Jacopo Oreglia, Silvio Klugmann, Paola Orrico, Anna Maria De Biase, Irene Bossi, Dario Gregori, Paolo Salvade |
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| Rok vydání: | 2006 |
| Předmět: |
medicine.medical_specialty
business.industry medicine.medical_treatment Cardiogenic shock Percutaneous coronary intervention Infarction medicine.disease Coronary circulation medicine.anatomical_structure Angioplasty Internal medicine cardiovascular system medicine Cardiology cardiovascular diseases Myocardial infarction diagnosis Myocardial infarction Thrombus Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of the American College of Cardiology. 48:1552-1559 |
| ISSN: | 0735-1097 |
| DOI: | 10.1016/j.jacc.2006.03.068 |
| Popis: | Objectives This study sought to test the hypothesis that thrombus removal, with a new manual thrombus-aspirating device, before primary percutaneous coronary intervention (PPCI) may improve myocardial reperfusion compared with standard PPCI in patients with ST-segment elevation acute myocardial infarction (STEMI). Background In STEMI patients, PPCI may cause thrombus dislodgment and impaired microcirculatory reperfusion. Controversial results have been reported with different systems of distal protection or thrombus removal. Methods One-hundred forty-eight consecutive STEMI patients, admitted within 12 h of symptom onset and scheduled for PPCI, were randomly assigned to PPCI (group 1) or manual thrombus aspiration before standard PPCI (group 2). Patients with cardiogenic shock, previous infarction, or thrombolytic therapy were excluded. Primary end points were complete (>70%) ST-segment resolution (STR) and myocardial blush grade (MBG) 3. Results Baseline clinical and angiographic characteristics were similar in the 2 groups. Comparing groups 1 and 2: complete STR 50% versus 68% (p Conclusions Manual thrombus aspiration before PPCI leads to better myocardial reperfusion and is associated with lower creatine kinase mass band fraction release, lower risk of distal embolization, and no reflow compared with standard PPCI. (Thrombus Aspiration Before Standard Primary Angioplasty Improves Myocardial Reperfusion in Acute Myocardial Infarction; http://clinicaltrials.gov/ct/show/NCT00257153 ). |
| Databáze: | OpenAIRE |
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