AIMS: To assess the impact of thrombus aspiration during primary percutaneous coronary intervention (PPCI) on the mortality of patients with ST-elevation myocardial infarction (STEMI) patients. METHODS AND RESULTS: Retrospective analysis of prospectively collected data on 2567 consecutive PPCI-treated STEMI patients between 2008 and 2011. Cox proportional hazard models and multiple logistic regression analysis were used to adjust for known covariates. Thrombectomy was performed in 1095 patients (42.7%). Post-PPCI thrombolysis in myocardial infarction 3 flow was more frequently achieved in the thrombectomy group [adjusted odds ratio (OR); 1.92, 95% confidence interval (CI): 1.34-2.76, P = 0.0004]. Overall in-hospital and longer term (mean follow-up 9.9 months) mortality rates were 4.5 and 9.0%, respectively. Thrombectomy was associated with a significant reduction in in-hospital (adjusted OR: 0.51, 95% CI: 0.29-0.93, P = 0.027) and longer term mortality [adjusted hazard ratio (HR): 0.69, 95% CI: 0.48-0.96, P = 0.028]. With propensity weighting, the adjusted HR for longer term mortality for thrombectomy was 0.43 (95% CI: 0.19-0.97; P = 0.042). The association between thrombectomy and reduced longer term mortality was only significant in those with a total ischaemic time ≤180min (P = 0.001) but not in patients with a total ischaemic time >180min (P = 0.99). CONCLUSION: This study of real-world, unselected STEMI patients demonstrates that thrombus aspiration during PPCI is associated with a significant reduction in mortality, especially in those with a short total ischaemic time. These findings support the use of thrombectomy during PPCI in this group of patients.
AIMS: To assess the impact of thrombus aspiration during primary percutaneous coronary intervention (PPCI) on the mortality of patients with ST-elevation myocardial infarction (STEMI) patients. METHODS AND RESULTS: Retrospective analysis of prospectively collected data on 2567 consecutive PPCI-treated STEMI patients between 2008 and 2011. Cox proportional hazard models and multiple logistic regression analysis were used to adjust for known covariates. Thrombectomy was performed in 1095 patients (42.7%). Post-PPCI thrombolysis in myocardial infarction 3 flow was more frequently achieved in the thrombectomy group [adjusted odds ratio (OR); 1.92, 95% confidence interval (CI): 1.34-2.76, P = 0.0004]. Overall in-hospital and longer term (mean follow-up 9.9 months) mortality rates were 4.5 and 9.0%, respectively. Thrombectomy was associated with a significant reduction in in-hospital (adjusted OR: 0.51, 95% CI: 0.29-0.93, P = 0.027) and longer term mortality [adjusted hazard ratio (HR): 0.69, 95% CI: 0.48-0.96, P = 0.028]. With propensity weighting, the adjusted HR for longer term mortality for thrombectomy was 0.43 (95% CI: 0.19-0.97; P = 0.042). The association between thrombectomy and reduced longer term mortality was only significant in those with a total ischaemic time ≤180min (P = 0.001) but not in patients with a total ischaemic time >180min (P = 0.99). CONCLUSION: This study of real-world, unselected STEMI patients demonstrates that thrombus aspiration during PPCI is associated with a significant reduction in mortality, especially in those with a short total ischaemic time. These findings support the use of thrombectomy during PPCI in this group of patients.
Authors: Johannes Blumenstein; Steffen Daniel Kriechbaum; Jürgen Leick; Alexander Meyer; Won-Keun Kim; Jan Sebastian Wolter; Maisun Abu-Samra; Kay Weipert; Matthias Bayer; Oliver Dörr; Claudia Walther; Christian W Hamm; Holger Nef; Christoph Liebetrau; Helge Möllmann Journal: J Thromb Thrombolysis Date: 2018-02 Impact factor: 2.300
Authors: Sophia N Stanford; Ahmed Sabra; Lindsay D'Silva; Matthew Lawrence; Roger H K Morris; Sharon Storton; Martyn Rowan Brown; Vanessa Evans; Karl Hawkins; Phylip Rhodri Williams; Simon J Davidson; Mushtaq Wani; John F Potter; Phillip A Evans Journal: BMC Neurol Date: 2015-03-15 Impact factor: 2.474
Authors: Veronika Barsukevich; Marina Basalay; Jenifer Sanchez; Alexander Mrochek; John Whittle; Gareth L Ackland; Alexander V Gourine; Andrey Gourine Journal: Basic Res Cardiol Date: 2014-12-02 Impact factor: 17.165
Authors: Göran K Olivecrona; Bo Lagerqvist; Ole Fröbert; Thórarinn Gudnason; Michael Maeng; Truls Råmunddal; Jan Haupt; Thomas Kellerth; Jason Stewart; Giovanna Sarno; Jens Jensen; Ollie Östlund; Stefan K James Journal: BMC Cardiovasc Disord Date: 2016-04-01 Impact factor: 2.298