Aspiration Thrombectomy in Patients with Acute Myocardial Infarction—5-Year Analysis Based on a Large National Registry (ORPKI)
| Autor: | Piotr Mika, Andrzej Surdacki, Tomasz Kameczura, Rafał Januszek, Zbigniew Siudak, Wojciech Wańha, Jacek Legutko, Roman Wojdyla, Stanisław Bartuś, Wojciech Wojakowski, Krzysztof Piotr Malinowski |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Percutaneous no-reflow phenomenon medicine.medical_treatment acute myocardial infarction lcsh:Medicine 030204 cardiovascular system & hematology Article 03 medical and health sciences 0302 clinical medicine Internal medicine medicine In patient 030212 general & internal medicine Myocardial infarction cardiovascular diseases Thrombus Stroke business.industry lcsh:R Percutaneous coronary intervention General Medicine medicine.disease primary percutaneous coronary intervention thrombus aspiration No reflow phenomenon Conventional PCI Cardiology business |
| Zdroj: | Journal of Clinical Medicine, Vol 9, Iss 3610, p 3610 (2020) Journal of Clinical Medicine Volume 9 Issue 11 National Information Processing Institute |
| ISSN: | 2077-0383 |
| Popis: | Blood flow restoration after primary percutaneous coronary intervention (pPCI) in patients with acute myocardial infarction (AMI) may not always be achieved and could be complicated by the no-reflow phenomenon (NRP). The aim of the current study was to assess the frequency of thrombus aspirations (TAs) and NRPs in patients with AMI and treated with pPCI based on the data collected during a 5-year period in the national ORPKI registry, as well as the frequency of periprocedural strokes and predictors of TA and NRP. This retrospective analysis was performed on prospectively collected data gathered in the Polish National Registry of Percutaneous Coronary Interventions (ORPKI), which covered the period between January 2014 and December 2018, and included 200,991 patients treated due to AMI out of 535,857 patients treated using PCI. Among them, 16,777 patients underwent TA. TA was mainly used in the STEMI subgroup of 14,207 patients (84.8%). The frequency of NRP among AMI patients in the thrombectomy group was 2.75% and in the non-thrombectomy group 0.82%. Predictors of TA and NRP were also assessed using multivariate analysis. The percentage of patients treated with pPCI and with PCI alone increased significantly in all of the three selected groups of patients from 88.7% to 94.3% in the AMI group (p < 0.001), from 82.3% to 90.3% in the STEMI subgroup (p < 0.001), and from 96.3% to 98.2% in the NSTEMI subgroup (p < 0.001) during the analysed period. NRP occurred more often in the thrombectomy group for the NSTEMI (0.58% vs. 3.07%, p < 0.05) and STEMI (1.06% vs. 2.69%, p < 0.05) subgroups. Periprocedural stroke occurred more often in the thrombectomy group in comparison to the non-thrombectomy group with AMI (0.03% vs. 0.01%, p < 0.05) and the NSTEMI (0.16% vs. 0.02%, p < 0.05). In conclusion, the frequency of TA has been experiencing a steady decline in recent years, regardless of AMI type, among patients treated with pPCI. |
| Databáze: | OpenAIRE |
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