title: Aspiration thrombectomy in patients with ST elevation myocardial infarction undergoing primary percutaneous coronary intervention (from the Acute Coronary Syndrome Israeli Survey 2010).
abstract: We assessed the impact of aspiration thrombectomy (AT) in patients with ST elevation myocardial infarction undergoing primary percutaneous coronary intervention (PPCI) on major adverse cardiac events at 30 days and 1-year mortality in 517 consecutive patients who were included in the prospective, nationwide, multicenter, observational Acute Coronary Syndrome Israeli Survey in 2010. Two hundred seventeen patients (42%) underwent AT (AT-PPCI) and 300 patients conventional (C) PPCI. Both groups had similar infarct-related artery distribution and ostial or proximal culprit lesion. Patients in AT-PPCI versus C-PPCI had lower systolic blood pressure and worse Killip class on admission, more frequent Thrombolysis In Myocardial Infarction flow 0 or 1 before PPCI (80% vs 56%), less frequent restoration of flow after indwelling a guidewire in the infarct-related artery (32% vs 52%), and more use of IIb/IIIa glycoprotein inhibitors (69% vs 49%), respectively (p ≤0.05 for all comparisons). Thirty-day major adverse cardiac events was similar in the AT-PPCI and C-PPCI groups, 10.6% versus 9.7%, p = 0.73; adjusted odds ratio 0.97, 95% confidence interval 0.45 to 2.10, p = 0.95. One-year mortality was lower in the AT-PPCI versus C-PPCI group, 3.7% versus 6.7%, p = 0.13; adjusted hazard ratio 0.31, 95% confidence interval 0.10 to 0.96, p = 0.042. In conclusion, this study of consecutive patients with ST elevation myocardial infarction undergoing PPCI demonstrates that AT was an independent predictor of reduced 1-year mortality.
authors.affiliation: Department of Cardiology, Shaare Zedek Medical Center, The Hebrew University Hadassah Medical School, Jerusalem, Israel. Electronic address: cardio@szmc.org.il.
authors.forename: Mady
authors.initials: M
authors.lastname: Moriel
authors.affiliation: Neufeld Cardiac Research Institute, Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Shlomi
authors.initials: S
authors.lastname: Matetzky
authors.affiliation: Neufeld Cardiac Research Institute, Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Amit
authors.initials: A
authors.lastname: Segev
authors.affiliation: Department of Cardiology, Shaare Zedek Medical Center, The Hebrew University Hadassah Medical School, Jerusalem, Israel.
authors.forename: Aaron
authors.initials: A
authors.lastname: Medina
authors.affiliation: Department of Cardiology, Beilinson Campus, Rabin Medical Center, Petach Tikva, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Ran
authors.initials: R
authors.lastname: Kornowski
authors.affiliation: Department of Cardiology, Hadassah Medical Center, The Hebrew University Hadassah Medical School, Jerusalem, Israel.
authors.forename: Haim
authors.initials: H
authors.lastname: Danenberg
authors.affiliation: Neufeld Cardiac Research Institute, Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Natalie
authors.initials: N
authors.lastname: Gavrielov-Yusim
authors.affiliation: Neufeld Cardiac Research Institute, Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Ilan
authors.initials: I
authors.lastname: Goldenberg
authors.affiliation: Department of Cardiology, Shaare Zedek Medical Center, The Hebrew University Hadassah Medical School, Jerusalem, Israel.
authors.forename: Dan
authors.initials: D
authors.lastname: Tzivoni
authors.affiliation: Department of Cardiology, Shaare Zedek Medical Center, The Hebrew University Hadassah Medical School, Jerusalem, Israel; Neufeld Cardiac Research Institute, Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Shmuel
authors.initials: S
authors.lastname: Gottlieb
mesh_terms: D000368:Aged; D003131:Combined Modality Therapy; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D062645:Percutaneous Coronary Intervention; D011446:Prospective Studies; D017131:Thrombectomy / Q000379:methods