title: Clinical impact of thrombus aspiration during primary percutaneous coronary intervention in acute myocardial infarction with occluded culprit.
abstract: Data regarding clinical efficacy of thrombectomy in patients with acute myocardial infarction (AMI) have been still limited in Japan. Using the AMI-Kyoto Multi-Center Risk Study database, the clinical background characteristics, angiographic findings, primary percutaneous coronary intervention (PCI) results and in-hospital prognoses were retrospectively compared between AMI patients with totally occluded infarct-related artery (IRA) (TIMI flow grade 0) undergoing thrombus aspiration during primary PCI (with-aspiration patients, n = 568) and those without thrombus aspiration (without-aspiration patients, n = 266). The with-aspiration patients were more likely to have higher TIMI grade in the IRA immediately after primary PCI, and had a lower in-hospital mortality rate than the without-aspiration patients. According to a multivariate analysis, thrombectomy as well as stent usage was found to be independent predictor of final TIMI flow grade ≥2 in the IRA, and the final TIMI flow grade ≥2 in the IRA was found to be an independent factor for in-hospital survival. These results suggest that among real-world, unselected Japanese AMI patients with totally occluded IRA on initial coronary angiography, thrombus aspiration is an effective adjunctive therapy during primary PCI to improve final epicardial coronary flow in the IRA, which might lead to better in-hospital prognosis.
authors.affiliation: Department of Cardiology, Kyoto First Red Cross Hospital, Honmachi, Higashiyama-ku, Kyoto, 605-0981, Japan, risa11221998@yahoo.co.jp.
authors.forename: Jun
authors.initials: J
authors.lastname: Shiraishi
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Kohno
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nakamura
authors.forename: Takashi
authors.initials: T
authors.lastname: Yanagiuchi
authors.forename: Sho
authors.initials: S
authors.lastname: Hashimoto
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ito
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Kimura
authors.forename: Akihiro
authors.initials: A
authors.lastname: Matsui
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Yokoi
authors.forename: Masayasu
authors.initials: M
authors.lastname: Arihara
authors.forename: Masayuki
authors.initials: M
authors.lastname: Hyogo
authors.forename: Takatomo
authors.initials: T
authors.lastname: Shima
authors.forename: Takahisa
authors.initials: T
authors.lastname: Sawada
authors.forename: Satoaki
authors.initials: S
authors.lastname: Matoba
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yamada
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Matsumuro
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shirayama
authors.forename: Makoto
authors.initials: M
authors.lastname: Kitamura
authors.forename: Keizo
authors.initials: K
authors.lastname: Furukawa
mesh_terms: D000368:Aged; D044466:Asian People; D003131:Combined Modality Therapy; D003328:Coronary Thrombosis / Q000601:surgery*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000601:surgery*; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011379:Prognosis; D017131:Thrombectomy / Q000379:methods*