Patients’ Complications in ST Segment Elevation Myocardial Infarction Managed with Primary Percutaneous Coronary Intervention with and without Thromboaspiration OC13-OC17
Dr. Behshad Naghshtabrizi,
Farshchian Heart Center, Fahmide Blvd, 65168, Hamadan, Iran.
Introduction: One of the biggest challenges for interventional cardiologist is subsequent distal embolization and disturbance in microvascular perfusion after a Percutaneous Coronary Intervention (PCI). Theoretically, manual thromboaspiration might be a useful way to prevent this complication. According to recent studies, the use of thromboaspiration does not have a significant effect.
Aim: To compare the clinical outcomes of patients managed with Primary PCI (PPCI) with and without thromboaspiration, based on coronary arteries flow and thrombus burden before the procedure.
Materials and Methods: A total of 249 patients who were admitted with ST Segment Elevation Myocardial Infarction (STEMI) to Farshchian Heart Center, Hamadan, Iran, during 2015-2017 were enrolled in our study. Patients were managed with PPCI with and without thromboaspiration and were classified as case and control groups, respectively. In the follow-up course of 30 days, complications including mortality, Major Adverse Cardiovascular Events (MACE) and stroke were evaluated. After collecting data, analysis was done with statistical software SPSS 18. Chi-square test and independent t-test were used for analysis. All statistical analyses were carried out at 95% confidence level.
Results: A total of 58 and 191 patients were managed with PPCI with and without thromboaspiration (case and control groups respectively). There was no significant difference in the occurrence of primary outcomes including mortality (1.72% vs. 2.62%, p-value=0.697), MACE (0 vs. 0.52%, p-value=0.581) and stroke (1.72% vs. 0.52%, p-value=0.370) in case and control groups respectively. Thrombolysis in Myocardial Infarction (TIMI) grade flow before the procedure was significantly higher in case group (p-value=00.1), but postprocedural TIMI grade flow was the same (p-value=0.450).
Conclusion: One-month clinical complications including mortality, MACE and stroke were similar in both the groups. Despite the lower TIMI grade flow before the procedure in the case group compared to the control group, a similar TIMI grade flow after the procedure was achieved, which indicate the usefulness of thromboaspiration in the patients with lower TIMI grade flow at presentation.