JavaScript NENÍ povolen !

* Zobrazit nápovědu

1 záznamů v Medvik Filtry

Článek online

Myocardial blush and microvascular reperfusion following manual thrombectomy during percutaneous coronary intervention for ST elevation myocardial infarction: insights from the TOTAL trial

Sharma, Vinoda
Autor Sharma, Vinoda Peter Munk Cardiac Centre, University Health Network, 6 Eaton North Room 232, Toronto, ON, Canada Toronto General Hospital, University Health Network, 200 Elizabeth Street, Toronto, ON Canada M5G 2C4
Jolly, Sanjit S
Autor Jolly, Sanjit S The Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton General Hospital, Hamilton, ON, Canada
Hamid, Tahir
Autor Hamid, Tahir Peter Munk Cardiac Centre, University Health Network, 6 Eaton North Room 232, Toronto, ON, Canada Toronto General Hospital, University Health Network, 200 Elizabeth Street, Toronto, ON Canada M5G 2C4
Sharma, Divyesh
Autor Sharma, Divyesh Peter Munk Cardiac Centre, University Health Network, 6 Eaton North Room 232, Toronto, ON, Canada Toronto General Hospital, University Health Network, 200 Elizabeth Street, Toronto, ON Canada M5G 2C4
Chiha, Joseph
Autor Chiha, Joseph Peter Munk Cardiac Centre, University Health Network, 6 Eaton North Room 232, Toronto, ON, Canada Toronto General Hospital, University Health Network, 200 Elizabeth Street, Toronto, ON Canada M5G 2C4
Chan, William
Autor Chan, William Peter Munk Cardiac Centre, University Health Network, 6 Eaton North Room 232, Toronto, ON, Canada Toronto General Hospital, University Health Network, 200 Elizabeth Street, Toronto, ON Canada M5G 2C4
Fuchs, Felipe
Autor Fuchs, Felipe Peter Munk Cardiac Centre, University Health Network, 6 Eaton North Room 232, Toronto, ON, Canada Toronto General Hospital, University Health Network, 200 Elizabeth Street, Toronto, ON Canada M5G 2C4
Bui, Sanh
Autor Bui, Sanh Peter Munk Cardiac Centre, University Health Network, 6 Eaton North Room 232, Toronto, ON, Canada Toronto General Hospital, University Health Network, 200 Elizabeth Street, Toronto, ON Canada M5G 2C4
Gao, Peggy
Autor Gao, Peggy The Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton General Hospital, Hamilton, ON, Canada
Kassam, Saleem
Autor Kassam, Saleem Rouge Valley Health System, Toronto, ON, Canada

European heart journal. 2016 ; 37 (24) : 1891-8. [pub] 20160428

Eur Heart J
ISSN 1522-9645
Medvik
Zdroj

AIMS: Thrombectomy during primary percutaneous coronary intervention (PPCI) for ST elevation myocardial infarction (STEMI) has been thought to be an effective therapy to prevent distal embolization and improve microvascular perfusion. The TOTAL trial (N = 10 732), a randomized trial of routine manual thrombectomy vs. PCI alone in STEMI, showed no difference in the primary efficacy outcome. This angiographic sub-study was performed to determine if thrombectomy improved microvascular perfusion as measured by myocardial blush grade (MBG). METHODS AND RESULTS: Of the 10 732 patients randomized, 1610 randomly selected angiograms were analysable by the angiographic core laboratory. Primary outcomes included MBG and post-PCI thrombolysis in myocardial infarction (TIMI) flow grade. Secondary outcomes included distal embolization, PPCI complications, and each component of the complications. The primary end point of final myocardial blush (221 [28%] 0/1 for thrombectomy vs. 246 {30%} 0/1 for PCI alone group, P = 0.38) and TIMI flow (712 [90%] TIMI 3 for thrombectomy vs. 733 [89.5%] TIMI 3 for PCI alone arm, P = 0.73) was similar in the two groups. Thrombectomy was associated with a significantly reduced incidence of distal embolization compared with PCI alone (56 [7.1%] vs. 87 [10.7%], P = 0.01). In multivariable analysis, distal embolization was an independent predictor of mortality (HR 3.00, 95% CI 1.19-7.58) while MBG was not (HR 2.73, 95% CI 0.94-5.3). CONCLUSIONS: Routine thrombectomy during PPCI did not result in improved MBG or post-PCI TIMI flow grade but did reduce distal embolization compared with PCI alone. Distal embolization and not blush grade is independently associated with mortality.

MeSH
balónková koronární angioplastika MeSH
infarkt myokardu s elevacemi ST úseků * MeSH
infarkt myokardu MeSH
koronární angiografie MeSH
koronární angioplastika MeSH
lidé MeSH
trombektomie * MeSH
výsledek terapie MeSH
Check Tag
lidé MeSH
Publikační typ
časopisecké články MeSH
práce podpořená grantem MeSH
randomizované kontrolované studie MeSH

Kolekce

Publikováno

Filtry

* Zobrazit nápovědu

* Zobrazit nápovědu

Upřesnit dle MeSH