Thrombus Aspiration in Patients with ST-Elevation Myocardial Infarction: Results of a National Registry of Interventional Cardiology

• Autor(a) principal: Pereira, H
• Data de Publicação: 2018
• Outros Autores: Caldeira, D, Campante Teles, R, Costa, M, Canas da Silva, P, da Gama Ribeiro, V, Brandão, V, Martins, D, Matias, F, Pereira-Machado, F, Baptista, J, Farto e Abreu, P, Santos, R, Drummond, A, Cyrne de Carvalho, H, Calisto, J, Silva, JC, Pipa, JL, Marques, J, Sousa, P, Fernandes, R, Cruz Ferreira, R, Ramos, S, Infante Oliveira, E, de Sousa Almeida, M
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10400.17/3019
• topic: HSM CAR; Coronary Thrombosis/diagnosis; Coronary Thrombosis/mortality; Portugal; Coronary Thrombosis/surgery; Hospital Mortality; Percutaneous Coronary Intervention/adverse effects; Percutaneous Coronary Intervention/mortality; Protective Factors; Registries; Retrospective Studies; Risk Assessment; Risk Factors; ST Elevation Myocardial Infarction/diagnosis; ST Elevation Myocardial Infarction/mortality; ST Elevation Myocardial Infarction/surgery; Thrombectomy/adverse effects; Thrombectomy/mortality; Time Factors; Treatment Outcome

BACKGROUND: We aimed to evaluate the impact of thrombus aspiration (TA) during primary percutaneous coronary intervention (P-PCI) in 'real-world' settings. METHODS: We performed a retrospective study, using data from the National Registry of Interventional Cardiology (RNCI 2006-2012, Portugal) with ST-elevation myocardial infarction (STEMI) patients treated with P-PCI. The primary outcome, in-hospital mortality, was analysed through adjusted odds ratio (aOR) and 95% confidence intervals (95%CI). RESULTS: We assessed data for 9458 STEMI patients that undergone P-PCI (35% treated with TA). The risk of in-hospital mortality with TA (aOR 0.93, 95%CI:0.54-1.60) was not significantly decreased. After matching patients through the propensity score, TA reduced significantly the risk of in-hospital mortality (OR 0.58, 95%CI:0.35-0.98; 3500 patients). CONCLUSIONS: The whole cohort data does not support the routine use of TA in P-PCI, but the results of the propensity-score matched cohort suggests that the use of selective TA may improve the short-term risks of STEMI.