Clinical impact of thrombus aspiration during primary percutaneous coronary intervention in acute myocardial infarction
- PDF / 214,846 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 17 Downloads / 191 Views
ORIGINAL ARTICLE
Clinical impact of thrombus aspiration during primary percutaneous coronary intervention in acute myocardial infarction with occluded culprit Jun Shiraishi • Yoshio Kohno • Takeshi Nakamura • Takashi Yanagiuchi • Sho Hashimoto • Daisuke Ito • Masayoshi Kimura • Akihiro Matsui • Hirokazu Yokoi • Masayasu Arihara • Masayuki Hyogo • Takatomo Shima • Takahisa Sawada • Satoaki Matoba • Hiroyuki Yamada Akiyoshi Matsumuro • Takeshi Shirayama • Makoto Kitamura • Keizo Furukawa
•
Received: 28 December 2013 / Accepted: 12 June 2014 / Published online: 2 July 2014 Ó Japanese Association of Cardiovascular Intervention and Therapeutics 2014
Abstract Data regarding clinical efficacy of thrombectomy in patients with acute myocardial infarction (AMI) have been still limited in Japan. Using the AMI-Kyoto Multi-Center Risk Study database, the clinical background characteristics, angiographic findings, primary percutaneous coronary intervention (PCI) results and in-hospital prognoses were retrospectively compared between AMI patients with totally occluded infarct-related artery (IRA) (TIMI flow grade 0) undergoing thrombus aspiration during primary PCI (with-aspiration patients, n = 568) and those without thrombus aspiration (without-aspiration
On behalf of the AMI-Kyoto Multi-Center Risk Study Group, the members of the group are listed in ‘‘Appendix’’. J. Shiraishi (&) Y. Kohno T. Yanagiuchi S. Hashimoto D. Ito M. Kimura A. Matsui H. Yokoi M. Hyogo T. Shima T. Sawada Department of Cardiology, Kyoto First Red Cross Hospital, Honmachi, Higashiyama-ku, Kyoto 605-0981, Japan e-mail: [email protected] T. Nakamura S. Matoba H. Yamada A. Matsumuro T. Shirayama Department of Cardiovascular Medicine, Kyoto Prefectural University School of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan M. Arihara Department of Emergency Medicine, Kyoto First Red Cross Hospital, Honmachi, Higashiyama-ku, Kyoto 605-0981, Japan M. Kitamura Department of Cardiology, Kyoto Second Red Cross Hospital, Kyoto, Japan K. Furukawa Department of Cardiology, Tanabe Central Hospital, Kyotanabe, Japan
123
patients, n = 266). The with-aspiration patients were more likely to have higher TIMI grade in the IRA immediately after primary PCI, and had a lower in-hospital mortality rate than the without-aspiration patients. According to a multivariate analysis, thrombectomy as well as stent usage was found to be independent predictor of final TIMI flow grade C2 in the IRA, and the final TIMI flow grade C2 in the IRA was found to be an independent factor for inhospital survival. These results suggest that among realworld, unselected Japanese AMI patients with totally occluded IRA on initial coronary angiography, thrombus aspiration is an effective adjunctive therapy during primary PCI to improve final epicardial coronary flow in the IRA, which might lead to better in-hospital prognosis. Keywords Acute myocardial infarction Aspiration Thrombectomy
Introduction Primary percutaneous coronary intervention (P
Data Loading...
