PMID- 25000125
OWN - NLM
STAT- MEDLINE
DCOM- 20161213
LR  - 20161230
IS  - 1827-1618 (Electronic)
IS  - 0026-4725 (Linking)
VI  - 63
IP  - 5
DP  - 2015 Oct
TI  - The prognostic role of renal dysfunction in STEMI patients submitted to primary 
      PCI with adjunctive thrombus aspiration.
PG  - 381-8
AB  - AIM: The present investigation was aimed at assessing the prognostic impact of 
      renal dysfunction rate in STEMI patients submitted to thrombectomy (TP). METHODS: 
      Out of 1268 consecutive ST elevation myocardial infarction (STEMI) patients 
      treated with pPCI from January 1rst 2004 to December 31th 2012 in our hospital 
      671 patients (52.9%) underwent adjunctive thrombus aspiration and constituted the 
      study population. Patients were divided into three groups according to eGFR: 
      group 1 included patients with eGFR>60 mL/min/m2, group 2 eGFR>30 mL/min/m2 and 
      <60 mL/min/m2, group 3 eGFR<30 mL/min/m2. The rate of utilization of 
      thrombectomy, the rate of pPCI failure and the incidence of major bleeding were 
      assessed in each subgroup. Patients in group 3 and group 2 were less likely to be 
      submitted to TP, while more than 50% of patients with normal eGFR underwent TP 
      (overall P=0.019). The rate of pPCI failure was significantly higher in group 2 
      and 3 when compared to group 1 (P=0.002). Worsening renal failure was associated 
      with a higher mortality rate both at ICCU and at 1 year follow-up (P<0.001 and 
      P<0.001, respectively). A higher incidence of major bleedings was reported in 
      group 2 and group 3, despite the lower administration of glycoprotein IIb/IIIa 
      inhibitors (P<0.001). Moderate and severe renal impairment was associated with a 
      higher mortality rate both at ICCU and at 1 year follow-up (P<0.001 and P<0.001, 
      respectively). CONCLUSION: Thrombus aspiration is less like to be performed among 
      patients with impaired renal function. Despite thrombus aspiration patients with 
      reduced eGFR showed a higher incidence of pPCI failure.
FAU - Mattesini, A
AU  - Mattesini A
AD  - Interventinal Cardiology Unit, Heart and Vessels Department, Azienda 
      Ospedaliero-Universitaria Careggi, Florence, Italy - amattesini@gmail.com.
FAU - Lazzeri, C
AU  - Lazzeri C
FAU - Chiostri, M
AU  - Chiostri M
FAU - Cordopatri, C
AU  - Cordopatri C
FAU - Sorini Dini, C
AU  - Sorini Dini C
FAU - Gensini, G F
AU  - Gensini GF
FAU - Valente, S
AU  - Valente S
LA  - eng
PT  - Journal Article
DEP - 20140707
PL  - Italy
TA  - Minerva Cardioangiol
JT  - Minerva cardioangiologica
JID - 0400725
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 0 (Platelet Glycoprotein GPIIb-IIIa Complex)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Follow-Up Studies
MH  - Hemorrhage/epidemiology
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Percutaneous Coronary Intervention/adverse effects/*methods
MH  - Platelet Aggregation Inhibitors/therapeutic use
MH  - Platelet Glycoprotein GPIIb-IIIa Complex/administration & dosage/antagonists & 
      inhibitors
MH  - Prognosis
MH  - Renal Insufficiency/*physiopathology
MH  - Retrospective Studies
MH  - ST Elevation Myocardial Infarction/mortality/*therapy
MH  - Thrombectomy/*methods
MH  - Thrombosis/surgery
EDAT- 2014/07/08 06:00
MHDA- 2016/12/15 06:00
CRDT- 2014/07/08 06:00
PHST- 2014/07/08 06:00 [entrez]
PHST- 2014/07/08 06:00 [pubmed]
PHST- 2016/12/15 06:00 [medline]
AID - R05Y9999N00A140049 [pii]
PST - ppublish
SO  - Minerva Cardioangiol. 2015 Oct;63(5):381-8. Epub 2014 Jul 7.