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- Title
Clinic Predictive Factors for Insufficient Myocardial Reperfusion in ST-Segment Elevation Myocardial Infarction Patients Treated with Selective Aspiration Thrombectomy during Primary Percutaneous Coronary Intervention.
- Authors
Tian, Jinfan; Liu, Yue; Song, Xiantao; Zhang, Min; Xu, Feng; Yuan, Fei; Lyu, Shuzheng
- Abstract
Background. Insufficient data are available on the potential benefit of selective aspiration and clinical predictors for no-reflow in STEMI patients undergoing primary percutaneous coronary intervention (PPCI) adjunct with aspiration thrombectomy. Objective. The aim of our study was to investigate clinical predictors for insufficient reperfusion in patients with high thrombus burden treated with PPCI and manual aspiration thrombectomy. Methods. From January 2011 till December 2015, 277 STEMI patients undergoing manual aspiration thrombectomy and PPCI were selected and 202 patients with a Thrombolysis in Myocardial Infarction (TIMI) thrombus grade 4~5 were eventually involved in our study. According to a cTFC value, patients were divided into Group I (cTFC > 40), namely, insufficient reperfusion group; Group II (cTFC ≤ 40), namely, sufficient reperfusion group. Results. Univariate analysis showed that hypertension, multivessel disease, time from symptom to PCI (≧4.8 hours), and postaspiration cTFC > 40 were negative predictors for insufficient reperfusion. After multivariate adjustment, age ≧ 60 years, hypertension, time from symptom to PCI (≧4.8 hours), and postaspiration cTFC > 40 were independently associated with insufficient reperfusion in STEMI patients treated with manual aspiration thrombectomy. Upfront intracoronary GP IIb/IIIa inhibitor (Tirofiban) was positively associated with improved myocardial reperfusion. Conclusion. Fully identifying risk factors will help to improve the effectiveness of selective thrombus aspiration.
- Subjects
CHI-squared test; COMBINED modality therapy; CONFIDENCE intervals; STATISTICAL correlation; DEMOGRAPHY; FISHER exact test; MULTIVARIATE analysis; MYOCARDIAL infarction; MYOCARDIAL reperfusion; MYOCARDIAL revascularization; PROBABILITY theory; RESEARCH funding; STATISTICS; T-test (Statistics); THROMBOSIS; TRANSLUMINAL angioplasty; VEIN surgery; RETROSPECTIVE studies; RECEIVER operating characteristic curves; DATA analysis software; DESCRIPTIVE statistics; ODDS ratio; MANN Whitney U Test
- Publication
BioMed Research International, 2016, Vol 2016, p1
- ISSN
2314-6133
- Publication type
Article
- DOI
10.1155/2016/3823809