Abstract:
OBJECTIVES:The aim of this study was to evaluate the use of a new manual thrombus-aspirating device in unselected patients with ST-segment elevation acute myocardial infarction (STEMI) undergoing urgent percutaneous coronary intervention (PCI). BACKGROUND:Failure to achieve myocardial reperfusion often occurs during PCI in patients with STEMI. The use of thrombus-aspirating devices might improve myocardial reperfusion by reducing distal embolization. METHODS:We prospectively randomized before coronary angiography 100 consecutive patients with STEMI to either standard PCI or PCI with manual thrombus-aspiration. Primary end points of the study were post-procedural rates of myocardial blush grade (MBG) > or =2 and ST-segment resolution (STR) > or =70%. Analyses were planned by intention to treat. RESULTS:Ninety-nine patients entered the analyses. The rates of post-procedural MBG > or =2 and STR > or =70% were, respectively, 68.0% and 44.9% in the thrombus-aspiration group compared with 58.0% and 36.7% in the standard PCI group: odds ratio (OR) 2.6 (95% confidence interval [CI] 1.2 to 5.9), p = 0.020, and 2.4 (95% CI 1.1 to 5.3), p = 0.034, respectively. Moreover, the rate of patients achieving both the angiographic and electrocardiographic (ECG) criteria of optimal reperfusion was significantly higher in the thrombus-aspiration group compared with standard PCI: 46.0% versus 24.5%, OR 2.6 (95% CI 1.1 to 6.2), p = 0.025. In multivariate analysis, randomization to thrombus-aspiration was a significant independent predictor of achievement of MBG > or =2 and STR > or =70% (p = 0.013). CONCLUSIONS:This prospective randomized study shows that manual thrombus-aspiration in unselected patients with STEMI undergoing primary or rescue PCI is clinically feasible and results in better angiographic and ECG myocardial reperfusion rates compared with those achieved by standard PCI.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Burzotta F,Trani C,Romagnoli E,Mazzari MA,Rebuzzi AG,De Vita M,Garramone B,Giannico F,Niccoli G,Biondi-Zoccai GG,Schiavoni G,Mongiardo R,Crea Fdoi
10.1016/j.jacc.2005.04.057subject
Has Abstractpub_date
2005-07-19 00:00:00pages
371-6issue
2eissn
0735-1097issn
1558-3597pii
S0735-1097(05)01210-6journal_volume
46pub_type
临床试验,杂志文章,随机对照试验abstract:OBJECTIVES:We sought to assess the dynamic temporal course of conduction recovery during and after radiofrequency (RF) catheter ablation of the cavotricuspid isthmus. BACKGROUND:Although cavotricuspid isthmus block is accepted as the best end point of ablation for typical flutter, conduction recovery is thought to und...
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