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Coronary Artery Disease| Volume 113, ISSUE 5, P809-814, March 01, 2014

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Aspiration Thrombectomy in Patients With ST Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention (from the Acute Coronary Syndrome Israeli Survey 2010)

Published:December 13, 2013DOI:https://doi.org/10.1016/j.amjcard.2013.11.032
Aspiration Thrombectomy in Patients With ST Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention (from the Acute Coronary Syndrome Israeli Survey 2010)
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      We assessed the impact of aspiration thrombectomy (AT) in patients with ST elevation myocardial infarction undergoing primary percutaneous coronary intervention (PPCI) on major adverse cardiac events at 30 days and 1-year mortality in 517 consecutive patients who were included in the prospective, nationwide, multicenter, observational Acute Coronary Syndrome Israeli Survey in 2010. Two hundred seventeen patients (42%) underwent AT (AT-PPCI) and 300 patients conventional (C) PPCI. Both groups had similar infarct-related artery distribution and ostial or proximal culprit lesion. Patients in AT-PPCI versus C-PPCI had lower systolic blood pressure and worse Killip class on admission, more frequent Thrombolysis In Myocardial Infarction flow 0 or 1 before PPCI (80% vs 56%), less frequent restoration of flow after indwelling a guidewire in the infarct-related artery (32% vs 52%), and more use of IIb/IIIa glycoprotein inhibitors (69% vs 49%), respectively (p ≤0.05 for all comparisons). Thirty-day major adverse cardiac events was similar in the AT-PPCI and C-PPCI groups, 10.6% versus 9.7%, p = 0.73; adjusted odds ratio 0.97, 95% confidence interval 0.45 to 2.10, p = 0.95. One-year mortality was lower in the AT-PPCI versus C-PPCI group, 3.7% versus 6.7%, p = 0.13; adjusted hazard ratio 0.31, 95% confidence interval 0.10 to 0.96, p = 0.042. In conclusion, this study of consecutive patients with ST elevation myocardial infarction undergoing PPCI demonstrates that AT was an independent predictor of reduced 1-year mortality.
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      Article info

      Publication history

      Published online: December 13, 2013
      Accepted: November 14, 2013
      Received in revised form: November 14, 2013
      Received: August 13, 2013

      Footnotes

      Drs. Moriel and Gottlieb contributed equally to this work.

      See page 813 for disclosure information.

      Identification

      DOI: https://doi.org/10.1016/j.amjcard.2013.11.032

      Copyright

      © 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.

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