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

Title
Clinical impact of thrombus aspiration during primary percutaneous coronary intervention: Results from Korea Acute Myocardial Infarction Registry
Author(s)
김영조Daisuke Hachinohe[Daisuke Hachinohe]정명호[정명호]Shigeru Saito[Shigeru Saito]김민철[김민철]조명훈[조명훈]Khurshid Ahmed[Khurshid Ahmed]황승환[황승환]이민구[이민구]심두선[심두선]박근호[박근호]김주한[김주한]홍영준[홍영준]안영근[안영근]강정채[강정채]김종현[김종현]채성철[채성철]허승호[허승호]성인환[성인환]홍택종[홍택종]최동훈[최동훈]조명찬[조명찬]김종진[김종진]승기배[승기배]정욱성[정욱성]장양수[장양수]나승원[나승원]배장호[배장호]박승정[박승정]
Keywords
NO-REFLOW PHENOMENON; PRIMARY ANGIOPLASTY; RANDOMIZED-TRIALS; THROMBOLYTIC THERAPY; THROMBECTOMY; REPERFUSION; ELEVATION; METAANALYSIS; BENEFIT; ARTERY
Issue Date
201205
Publisher
ELSEVIER IRELAND LTD
Citation
JOURNAL OF CARDIOLOGY, v.59, no.3, pp.249 - 257
Abstract
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. (C) 2012 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.
URI
http://hdl.handle.net/YU.REPOSITORY/28283http://dx.doi.org/10.1016/j.jjcc.2011.12.005
ISSN
0914-5087
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의과대학 > 내과학교실 > Articles
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