PMID- 16251226
OWN - NLM
STAT- MEDLINE
DCOM- 20060718
LR  - 20181113
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Print)
IS  - 1355-6037 (Linking)
VI  - 92
IP  - 7
DP  - 2006 Jul
TI  - Impact of intracoronary aspiration thrombectomy during primary angioplasty on 
      left ventricular remodelling in patients with anterior ST elevation myocardial 
      infarction.
PG  - 951-7
AB  - OBJECTIVE: To evaluate prospectively the impact on left ventricular (LV) 
      remodelling of an intracoronary aspiration thrombectomy device as adjunctive 
      therapy in primary percutaneous coronary intervention (PCI) in patients with 
      anterior ST elevation myocardial infarction (STEMI). METHODS: 76 consecutive 
      patients with anterior STEMI (65.3 (11.2) years, 48 men) were randomly assigned 
      to intracoronary thrombectomy and stent placement (n = 38) or to conventional 
      stenting (n = 38) of the infarct related artery. Each patient underwent 
      transthoracic echocardiography immediately after PCI and at six months. At the 
      time of echocardiographic control, major adverse cardiovascular events (MACE) in 
      terms of death, new onset of myocardial infarction, and hospitalisation for heart 
      failure were also evaluated. RESULTS: After a successful primary PCI, patients in 
      the thrombectomy group achieved a higher rate of post-procedure myocardial blush 
      grade 3 (36.8% v 13.1%, p = 0.03) and effective ST segment resolution at 90 
      minutes (81.6% v 55.3%, p = 0.02). Six months after the index intervention, 19 
      patients (26.8%) developed LV dilatation, defined as an increase in end diastolic 
      volume (EDV) >or= 20%: 15 in the conventional group and four in the thrombectomy 
      group (p = 0.006). Accordingly, at six months patients treated conventionally had 
      significantly higher end systolic volumes (82 (7.7) ml v 75.3 (4.9) ml, p < 
      0.0001) and EDV (152.5 (18.1) ml v 138.1 (10.7) ml, p < 0.0001) than patients 
      treated with thrombectomy. No differences in cumulative MACE were observed (10.5% 
      in the conventional group v 8.6% in the thrombectomy group, not significant). 
      CONCLUSION: Compared with conventional stenting, adjunctive aspiration 
      thrombectomy in successful primary PCI seems to be associated with a 
      significantly lower incidence of LV remodelling at six months in patients with 
      anterior STEMI.
FAU - De Luca, L
AU  - De Luca L
AD  - Department of Cardiovascular and Respiratory Sciences, La Sapienza University, 
      Rome, Italy. leodeluca@virgilio.it
FAU - Sardella, G
AU  - Sardella G
FAU - Davidson, C J
AU  - Davidson CJ
FAU - De Persio, G
AU  - De Persio G
FAU - Beraldi, M
AU  - Beraldi M
FAU - Tommasone, T
AU  - Tommasone T
FAU - Mancone, M
AU  - Mancone M
FAU - Nguyen, B L
AU  - Nguyen BL
FAU - Agati, L
AU  - Agati L
FAU - Gheorghiade, M
AU  - Gheorghiade M
FAU - Fedele, F
AU  - Fedele F
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20051026
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
SB  - IM
CIN - Heart. 2006 Jul;92(7):867-9. PMID: 16670099
MH  - Adult
MH  - Aged
MH  - Angioplasty, Balloon, Coronary/*methods
MH  - Biopsy, Needle/instrumentation/methods
MH  - Cardiac Catheterization
MH  - Coronary Angiography
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/physiopathology/*therapy
MH  - Myocardial Revascularization/*methods
MH  - Observer Variation
MH  - Prospective Studies
MH  - Stents
MH  - Thrombectomy/*methods
MH  - Ventricular Remodeling/physiology
PMC - PMC1860693
COIS- Competing interests: None declared
EDAT- 2005/10/28 09:00
MHDA- 2006/07/19 09:00
PMCR- 2009/07/01
CRDT- 2005/10/28 09:00
PHST- 2005/10/28 09:00 [pubmed]
PHST- 2006/07/19 09:00 [medline]
PHST- 2005/10/28 09:00 [entrez]
PHST- 2009/07/01 00:00 [pmc-release]
AID - hrt.2005.074716 [pii]
AID - ht74716 [pii]
AID - 10.1136/hrt.2005.074716 [doi]
PST - ppublish
SO  - Heart. 2006 Jul;92(7):951-7. doi: 10.1136/hrt.2005.074716. Epub 2005 Oct 26.