Clinical impact of thrombus aspiration during primary percutaneous coronary intervention: Results from Korea Acute Myocardial Infarction Registry

详细信息	查看全文 | 推荐本文 |

• 作者：Daisuke Hachinohe ; MD^a ; ^b ; Myung Ho Jeong ; MD^a ; ^{myungho@chollian.net} ; Shigeru Saito ; MD^b ; Min Chol Kim ; MD^a ; Kyung Hoon Cho ; MD^a ; Khurshid Ahmed ; MD^a ; Seung Hwan Hwang ; MD^a ; Min Goo Lee ; MD^a ; Doo Sun Sim ; MD^a ; Keun-Ho Park ; MD^a ; Ju Han Kim ; MD^a ; Young Joon Hong ; MD^a ; Youngkeun Ahn ; MD^a ; Jung Chaee Kang ; MD^a ; Jong Hyun Kim ; MD^c ; Shung Chull Chae ; MD^d ; Young Jo Kim ; MD^e ; Seung Ho Hur ; MD^f ; In Whan Seong ; MD^g ; Taek Jong Hong ; MD^h ; Donghoon Choi ; MDⁱ ; Myeong Chan Cho ; MD^j ; Chong Jin Kim ; MD^k ; Ki Bae Seung ; MD^l ; Wook Sung Chung ; MD^l ; Yang Soo Jang ; MDⁱ ; Seung Woon Rha ; MD^m ; Jang Ho Bae ; MDⁿ ; Seung Jung Park ; MD^o ; other Korea Acute Myocardial Infarction Registry Investigators
• 关键词：ST-elevation myocardial infarction ; Thrombus aspiration ; Percutaneous coronary intervention
• 刊名：Journal of Cardiology
• 出版年：2012
• 期刊代码：P90_09145087
• 类别：med
• 出版时间：May, 2012
• 卷：59
• 期：3
• 页码：249-257
• 文件大小：689 K

摘要

| Figures/TablesFigures/Tables | ReferencesReferences

Summary

Background

The role of thrombus aspiration (TA) as an adjunct to primary percutaneous coronary intervention (PPCI) remains a matter of controversy.

Methods and results

A total of 2105 patients enrolled in the nationwide prospective Korea Acute Myocardial Infarction Registry, a cohort of 745 (35.4%) patients who underwent TA during PPCI was compared with 1360 (64.6%) patients who underwent conventional PCI without TA. Clinical outcomes at 12-months of overall enrolled patients and subgroups according to key variables were assessed using Cox regression models adjusted by propensity score. Although there was no significant difference among overall patients, in subgroup analyses, administration of glycoprotein (GP) IIb/IIIa inhibitor during PPCI [adjusted hazard ratio (HR) 0.329, 95%confidence interval (CI) 0.126-0.860, p = 0.023] and left anterior descending (LAD) as a culprit lesion (adjusted HR 0.516, 95%CI 0.275-0.971, p = 0.040) were the settings, in which TA was associated with a lower major adverse cardiac events (MACE) rate compared with non-TA.

Conclusions

Although TA does not improve clinical outcomes in overall patients who underwent PPCI, TA for LAD occlusion improves 12-month MACE. Furthermore, use of GP IIb/IIIa inhibitor with TA has a synergistic effect on clinical outcomes.