Long-term outcome after thrombectomy in acute myocardial infarction.
BACKGROUND
Current data appear in favour of thrombectomy for ST-elevation myocardial infarction (STEMI). However, information on long-term outcome after thrombectomy is limited. We performed a retrospective long-term study to assess the risk of cardiac re-hospitalizations and survival after discharge from the index hospitalization for STEMI.


METHODS
Patients originally randomized to percutaneous coronary intervention (PCI) with thrombectomy vs. standard PCI were included in a retrospective long-term observational study. The primary study endpoint was the combined risk for all-cause death or cardiac re-hospitalization after index discharge under optimal medical therapy. The cumulative number of cardiac hospitalization days and ventricular remodelling assessed by echocardiography and plasma biomarkers were secondary endpoints.


RESULTS
Of 94 STEMI patients who had been randomized between 11/2000 and 03/2003, 89 patients consented to long-term follow-up. A total of 43 patients had been allocated to thrombectomy and 46 to standard primary PCI. The minimum follow-up time was 1115 days. There was a significantly lower risk for death or cardiac re-hospitalization for patients of the thrombectomy group (hazard ratio = 0.69, 95% CI: 0.49-0.98, P = 0.036). The incidence of recurrent myocardial infarction was not different (P = 0.343). No differences in cardiac remodelling were detected by echocardiography, with the exception that heart-type fatty acid binding protein at 53.2 +/- 17 months was lower in the thrombectomy group (P = 0.045).


CONCLUSIONS
Thrombectomy in STEMI may decrease the long-term risk for death or cardiac re-hospitalization.
Adlbrecht
C
C
Medical University of Vienna, 1090 Vienna, Austria.
Distelmaier
K
K
Bonderman
D
D
Beran
G
G
Redwan
B
B
Strunk
G
G
Binder
T
T
Jakowitsch
J
J
Probst
P
P
Heinze
G
G
Maurer
G
G
Lang
I M
IM
D000208:Acute Disease; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002423:Cause of Death; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D010359:Patient Readmission; D012306:Risk; D017131:Thrombectomy; D016896:Treatment Outcome; D014463:Ultrasonography
D015415:Biomarkers