| Autor: |
Piero, Custodio-Sánchez, Félix, Damas-De Los Santos, Marco A, Peña-Duque, Daniel, Coutiño-Castelán, Eduardo, Arias-Sánchez, Arturo, Abundes-Velasco, Oscar, Castro-Alvarado, Franklyn A, Colon-Arias, Carlos, Alvarenga-Fajardo, César, Hernández-Fonseca, Erika, Rodríguez-Barriga, Adolfo, Hernández-Padilla |
| Rok vydání: |
2018 |
| Předmět: |
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| Zdroj: |
Archivos de cardiologia de Mexico. 88(5) |
| ISSN: |
1665-1731 |
| Popis: |
Reclassification of a large thrombus burden is an independent predictor of major adverse cardiac events and no-reflow in patients with ST- segment elevation myocardial infarction (STEMI). Patients with a greater residual thrombus burden have worse microvascular dysfunction and greater myocardial damage.A retrospective analysis was performed on 833 STEMI patients who underwent primary percutaneous coronary intervention. The final residual thrombus burden was reclassified after the lesion was wired, and a thrombus aspiration or balloon dilatation was performed to restore and stabilise a thrombolysis in myocardial infarction (TIMI) 2-3 flow. Deferred stenting (DEI) was compared with immediate stenting (ISI) group, and the primary outcome was the incidence of no-/slow-reflow (TIMI ≤ 2, or TIMI 3 with myocardial blush grade2).Overall, 47 patients (6.8%) had a residual large thrombus burden reclassified. The right coronary artery was the culprit vessel in 34 cases. More patients had coronary ectasia in the DSI group (P=.005). Fewer patients in the DSI had no-/slow-reflow (36% vs. 58%), and the myocardial blush grade 3 was more frequent in the DSI group (P=.005). After repeat coronary angiography in the DSI group, stenting was not performed in 56%, and oral anticoagulation was more frequent in the follow-up (P=.031). Major cardiac adverse events were similar between groups. There was a tendency to better left ventricular function in the DSI group (P=.056).Deferred stenting may be an efficient option in STEMI patients with a residual large thrombus burden reclassified after achieving a stable TIMI 2-3 flow. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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