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Outcome of thrombus aspiration in STEMI patients: a propensity score-adjusted study.
Blumenstein, Johannes; Kriechbaum, Steffen Daniel; Leick, Jürgen; Meyer, Alexander; Kim, Won-Keun; Wolter, Jan Sebastian; Abu-Samra, Maisun; Weipert, Kay; Bayer, Matthias; Dörr, Oliver; Walther, Claudia; Hamm, Christian W; Nef, Holger; Liebetrau, Christoph; Möllmann, Helge.
Afiliação
  • Blumenstein J; Department of Cardiology, Kerckhoff Heart and Thorax Center, German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Benekestrasse 2-8, 61231, Bad Nauheim, Germany.
  • Kriechbaum SD; Department of Cardiology, Kerckhoff Heart and Thorax Center, German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Benekestrasse 2-8, 61231, Bad Nauheim, Germany. s.kriechbaum@kerckhoff-klinik.de.
  • Leick J; Department of Cardiology, Kerckhoff Heart and Thorax Center, German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Benekestrasse 2-8, 61231, Bad Nauheim, Germany.
  • Meyer A; Department of Cardiac Surgery, Kerckhoff Heart and Thorax Center, Benekestraße 2-8, 61231, Bad Nauheim, Germany.
  • Kim WK; Department of Cardiology, Kerckhoff Heart and Thorax Center, German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Benekestrasse 2-8, 61231, Bad Nauheim, Germany.
  • Wolter JS; Division of Cardiology and Angiology, Department of Internal Medicine I, Justus Liebig University of Giessen, Klinikstraße 33, 35392, Giessen, Germany.
  • Abu-Samra M; Department of Cardiology, Kerckhoff Heart and Thorax Center, German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Benekestrasse 2-8, 61231, Bad Nauheim, Germany.
  • Weipert K; Division of Cardiology and Angiology, Department of Internal Medicine I, Justus Liebig University of Giessen, Klinikstraße 33, 35392, Giessen, Germany.
  • Bayer M; Division of Cardiology and Angiology, Department of Internal Medicine I, Justus Liebig University of Giessen, Klinikstraße 33, 35392, Giessen, Germany.
  • Dörr O; Division of Cardiology and Angiology, Department of Internal Medicine I, Justus Liebig University of Giessen, Klinikstraße 33, 35392, Giessen, Germany.
  • Walther C; Division of Cardiology and Angiology, Department of Internal Medicine I, Justus Liebig University of Giessen, Klinikstraße 33, 35392, Giessen, Germany.
  • Hamm CW; Department of Cardiology, Kerckhoff Heart and Thorax Center, German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Benekestrasse 2-8, 61231, Bad Nauheim, Germany.
  • Nef H; Department of Cardiology, Kerckhoff Heart and Thorax Center, German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Benekestrasse 2-8, 61231, Bad Nauheim, Germany.
  • Liebetrau C; Division of Cardiology and Angiology, Department of Internal Medicine I, Justus Liebig University of Giessen, Klinikstraße 33, 35392, Giessen, Germany.
  • Möllmann H; Department of Cardiology, Kerckhoff Heart and Thorax Center, German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Benekestrasse 2-8, 61231, Bad Nauheim, Germany.
J Thromb Thrombolysis ; 45(2): 240-249, 2018 Feb.
Article em En | MEDLINE | ID: mdl-29274046
The use of thrombus aspiration (TA) prior to primary percutaneous coronary intervention (PPCI) has undergone a radical change in intervention guidelines. The clinical implications, however, are still under scrutiny. This study investigated the clinical effects and outcome of TA before PPCI in patients with ST-segment elevation myocardial infarction (STEMI). Overall 1027 patients with STEMI were analyzed in this retrospective, propensity score-adjusted, multicenter study. The primary endpoints were in-hospital and long-term mortality. There were 418 patients in the TA group and 609 in the conventional PPCI group. The in-hospital mortality rate was significantly higher in the TA group (8.7 vs. 5.0%; P = 0.03). During long-term follow-up [median follow-up duration 689 days (IQR 405-959)] the mortality rates were similar (TA 14.3%, conventional PPCI 15.0%; P = 0.85). Survival analysis for the complete observation period revealed no significant benefit of TA [hazard ratio (HR) 1.12; 97.5% CI 0.90-0.71; P = 0.63]. There were also no significant differences between the groups in the following secondary endpoints: composite of cardiovascular death and non-fatal reinfarction at discharge (P = 0.39), post-PPCI thrombolysis in myocardial infarction flow-grade-3 (P = 0.14), left ventricular ejection fraction (P = 0.47), and non-fatal reinfarction during follow-up (P = 0.17). Rehospitalization rate (1.82 vs. 10.3%; P < 0.0001) and Canadian Cardiovascular Society (CCS) grading (P = 0.02) during follow-up were significantly lower in the TA group. In our cohort the in-hospital mortality rate was significantly higher for TA patients, but during long-term follow-up the mortality rates did not differ. The incidence of rehospitalization and CCS grading were lower in the TA-treated patients.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Trombectomia / Infarto do Miocárdio com Supradesnível do Segmento ST Tipo de estudo: Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Humans / Male / Middle aged Idioma: En Revista: J Thromb Thrombolysis Assunto da revista: ANGIOLOGIA Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Alemanha

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Trombectomia / Infarto do Miocárdio com Supradesnível do Segmento ST Tipo de estudo: Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Humans / Male / Middle aged Idioma: En Revista: J Thromb Thrombolysis Assunto da revista: ANGIOLOGIA Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Alemanha