TITLE

Thrombus aspiration in ST elevation myocardial infarction: comparative efficacy in patients treated early and late after onset of symptoms

AUTHOR(S)
De Vita, Maria; Burzotta, Francesco; Porto, Italo; Dudek, Dariusz; Lefèvre, Thierry; Trani, Carlo; Mielecki, Waldemar; Niccoli, Giampaolo; Biondi-Zoccai, Giuseppe G. L.; Crea, Filippo
PUB. DATE
August 2010
SOURCE
Heart;Aug2010, Vol. 96 Issue 16, p1287
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background Restoration of myocardial perfusion is the goal of percutaneous coronary intervention (PCI) in patients with ST elevation myocardial infarction. A major predictor of no-reflow is the increasing time to treatment (TTT). Thrombus aspiration (TA) is reported to improve myocardial reperfusion as compared with standard PCI (SP). Objective To investigate the influence of TTT on TA efficacy. Design Pooled analysis of individual patients' data of three prospective randomised trials comparing TA and SP. Patients A total of 299 patients (150 in TA group and 149 in SP group) entered the study. The study population was divided into three subgroups according to the TTT: ≤3 h (short TTT subgroup), >3 h to ≤6 h (intermediate TTT subgroup), >6 h to ≤12 h (long TTT subgroup). Main outcome measures The goal of the study was the comparison of optimal myocardial reperfusion, defined as the combination of myocardial blush grade 2 or 3 at post-PCI angiography and ST resolution more than 70% at post-PCI ECG, between SP and TA according to TTT. Results In the SP group, increasing TTT was associated with a decreased rate of optimal reperfusion (27.4% vs 17.9% vs 10%, p for trend=0.06), whereas in the TA group the same trend was not seen (40.9% vs 33.8% vs 50%, p for trend=0.93). In a multivariate logistic regression model, a significant interaction (p=0.04) between time to treatment and thrombus aspiration was observed. Conclusions TA limits the adverse effects of TTT prolongation on myocardial reperfusion.
ACCESSION #
55115928

 

Related Articles

  • Coronary grafts flow and cardiac pacing modalities: how to improve perioperative myocardial perfusion. D'Ancona, Giuseppe; Hargrove, Martin; Hinchion, John; Ramesh, B.C.; Chughtai, Jehan Zeb; Anjum, Muhammad Nadeem; O'Donnell, Aonghus; Aherne, Tom // European Journal of Cardio-Thoracic Surgery;Jul2004, Vol. 26 Issue 1, p85 

    Objective: Aim of this study was to investigate modifications of coronary grafts flow during different pacing modalities after CABG. Materials and methods: Two separate prospective studies were conducted in patients undergoing CABG and requiring intraoperative epicardial pacing. In a first study...

  • Primary PCI in STEMI: The Role of Thromboaspiration. Vaina, Sophia // Hospital Chronicles;2014 Supplement 1, Vol. 9, p1 

    The article focuses on the use of thromboaspiration during primary percutaneous coronary interventions (pPCI) in ST elevation myocardial infarction (STEMI). Topics include the results of the Thrombus Aspiration during Percutaneous coronary intervention in Acute myocardial infarction Study...

  • Thrombus aspiration during PCI improved clinical outcomes. Raible, Eric // Cardiology Today;Mar2008, Vol. 11 Issue 3, p23 

    The article discusses research being done on the use of thrombus aspiration in percutaneous coronary intervention (PCI). It references a study by T. Svilaas and others published in a 2008 issue of "New England Journal of Medicine." Based on the study, the use of aspiration to remove...

  • Intracoronary Abciximab and Aspiration Thrombectomy in Patients With Large Anterior Myocardial Infarction: The INFUSE-AMI Randomized Trial. Stone, Gregg W.; Maehara, Akiko; Witzenbichler, Bernhard; Godlewski, Jacek; Parise, Helen; Dambrink, Jan-Henk E.; Ochala, Andrzej; Carlton, Trevor W.; Cristea, Ecaterina; Wolff, Steven D.; Brener, Sorin J.; Chowdhary, Saqib; El-Omar, Magdi; Neunteufl, Thomas; Metzger, D. Christopher; Karwoski, Theodore; Dizon, Jose M.; Mehran, Roxana; Gibson, C. Michael // JAMA: Journal of the American Medical Association;5/2/2012, Vol. 307 Issue 17, p1817 

    The article discusses a study on the role of bolus intracoronary abciximab and manual aspiration thrombectomy in reducing infarct size in high-risk patients with ST-segment elevation myocardial infarction (STEMI). Suboptimal myocardial perfusion and increased infarct size resulting from STEMI...

  • Tako-tsubo Cardiomyopathy: A Review of the Literature. Dorfman, Todd A.; Aqel, Raed; Mayhew, Marc; Iskandrian, Ami E. // Current Cardiology Reviews;2007, Vol. 3 Issue 2, p137 

    The diagnosis of Takotsubo cardiomyopathy (TC) must be considered in all patients who develop transient left ventricular apical (or mid ventricular) ballooning in the absence of obstructive coronary artery disease (CAD). Although the prevalence of TC remains unknown, approximately 2% of all...

  • Takotsubo cardiomyopathy in a patient undergoing hemodialysis. Takemoto, Fumi; Chihara, Norio; Sawa, Naoki; Hoshino, Junichi; Yamanouchi, Masayuki; Hayami, Noriko; Hasegawa, Eiko; Suwabe, Tatsuya; Nakanishi, Shohei; Nakamura, Michiro; Mitani, Haruo; Ubara, Yoshifumi; Takaichi, Kenmei; Ohno, Minoru // Kidney International;Aug2009, Vol. 76 Issue 4, p467 

    The article presents a medical case of a 61-year-old woman who is hospitalized for cervical spondylosis and who suffered severe chest pain and dyspnea during a hemodialysis session. When she undergone electrocardiography (ECG), results show ST-segment elevation in the precordial leads, and Q...

  • Gemcitabine and Acute Myocardial Infarction. Bdair, Fadi M.; Graham, Susan P.; Smith, Patrick F.; Javie, Milind M. // Angiology;May/Jun2006, Vol. 57 Issue 3, p367 

    The objective of this paper is to report a case of acute, non-q-wave myocardial infarction, presumably secondary to gemcitabine chemotherapy for nonsmall cell lung cancer. A 43-year-old woman with postpartum cardiomyopathy and ischemic heart disease was treated with gemcitabine for metastatic...

  • Improvements in total mortality and lipid levels after acute myocardial infarction in an English health district (1995-1999). Harrop, J; Donnelly, R; Rowbottom, A; Holt, M; Scott, A R // Heart;May2002, Vol. 87 Issue 5, p428 

    Objectives: To quantify changes in 30 day and one year mortality among patients with acute myocardial infarction in southern Derbyshire (population 560 000) in each of five consecutive years (1995-1999) before the publication of the National Service Framework for coronary heart disease, and to...

  • Giant left ventricular thrombus after radiofrequency ablation of post-infarction ventricular tachycardia: what to do? Benezet-Mazuecos, J.; Marcos-Alberca, P.; Farre, J. // Heart;Dec2005, Vol. 91 Issue 12, p1532 

    The article presents a case study of a giant left ventricular (LV) thrombus after radiofrequency ablation of post-infarction ventricular tachycardia. A LV thrombus may develop as a complication of acute myocardial infarction, ventricular aneurysm, dilated cardiomyopathy, tako-tsubo transient...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sign out of this library

Other Topics