Routine aspiration thrombectomy improves the diagnosis and management of embolic myocardial infarction
| Autor: | Alex L, Huang, J Conleth, Murphy, Elizabeth, Shaw, Rebecca, Kozor, Warren, Yan, Anne, Loxton, Soon Y, Soo Hoo, Gemma A, Figtree, Helge H, Rasmussen, Peter S, Hansen, Gregory I C, Nelson, Ravinay, Bhindi, Michael R, Ward |
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| Rok vydání: | 2014 |
| Předmět: |
Aged
80 and over Male Rupture Spontaneous Embolism Myocardial Infarction Administration Oral Anticoagulants Coronary Artery Disease Middle Aged Unnecessary Procedures Coronary Angiography Plaque Atherosclerotic Percutaneous Coronary Intervention Treatment Outcome Predictive Value of Tests Risk Factors Humans Female Platelet Aggregation Inhibitors Aged Thrombectomy |
| Zdroj: | Catheterization and cardiovascular interventions : official journal of the Society for Cardiac AngiographyInterventions. 87(4) |
| ISSN: | 1522-726X |
| Popis: | Assess the effect of aspiration thrombectomy on diagnosis and management of embolic acute myocardial infarction.Discrimination of embolic acute myocardial infarction from atherosclerotic plaque rupture/erosion prompts oral anticoagulation treatment of source of embolus, as well as avoiding unnecessary stenting and dual antiplatelet therapy. However, detection is difficult without aspiration.We compared rates of diagnosis of embolic infarction for 2.5 years prior to (pre-RAT) and 2.5 years post routine aspiration thrombectomy (post-RAT). Baseline demographics, outcomes, and treatment strategies were also compared between the embolic infarction and atherosclerotic infarction.Diagnosed embolic infarction rose from 1.2% in the pre-RAT era to 2.8% in the post-RAT period (P 0.05). In addition, more successful removal of thrombus by aspiration led to less stenting (20% vs. 55% P 0.05) in the post-RAT period thus avoiding the hazards of "triple therapy." Embolic infarction was more frequently associated with atrial fibrillation (55% vs. 8%), had higher mortality (17% vs. 4%), and had higher rates of embolic stroke (13% vs. 0.3%) when compared with atherosclerotic MI (all P 0.05).Routine aspiration thrombectomy more readily identifies embolic infarction allowing more specific therapy and avoidance of stenting and triple anticoagulant therapy. |
| Databáze: | OpenAIRE |
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