title: Local Intracoronary Eptifibatide versus Mechanical Aspiration in Patients with Acute ST-Elevation Myocardial Infarction.
abstract: Objectives. We compared local delivery of intracoronary eptifibatide via perfusion catheter to thrombus aspiration in primary PCI. Background. Perfusion catheter increases local concentration of the drugs at the culprit site and prolongs their residency time. Methods. 75 patients with acute STEMI were randomized to three groups: 25 received local intracoronary eptifibatide and verapamil via perfusion catheter; 25 patients were managed by Diver CE thrombectomy device and 25 patients by primary PCI without thrombus aspiration. Primary end point was assessment of postprocedural TIMI flow, MPG, and corrected TIMI frame count (cTFC) in the culprit vessel. Results. Perfusion catheter was superior to thrombus aspiration and conventional PCI as regards MBG (68% versus 36% in Diver CE and 20% in the control arm; P value = 0.002), with shorter cTFC rates than thrombectomy and control groups (20.76 ± 4.44 versus 26.68 ± 8.40 and 28.16 ± 5.96, resp.; P = 0.001). TIMI flow was not different between the 3 groups. Eptifibatide led to less time to peak CK (13.12 hours versus 16.5 and 19.5 hours, respectively, P value = 0.001). Conclusion. Local intracoronary eptifibatide by perfusion catheter reduces thrombus burden with better results in microvascular perfusion assessed by cTFC and MBG compared to aspiration device or conventional PCI.
authors.affiliation: Ain Shams University, P.O. Box 11381, Cairo, Egypt ; Cardiology Department, Ain Shams University, Lotfy Elsayed Street, Abbaseya, P.O. Box 11381, Cairo, Egypt.
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Hamza
authors.affiliation: Ain Shams University, P.O. Box 11381, Cairo, Egypt.
authors.forename: Ayman
authors.initials: A
authors.lastname: Galal
authors.affiliation: Ain Shams University, P.O. Box 11381, Cairo, Egypt.
authors.forename: Salwa
authors.initials: S
authors.lastname: Suweilam
authors.affiliation: Ain Shams University, P.O. Box 11381, Cairo, Egypt.
authors.forename: Mohamed
authors.identifier: 0000-0001-7404-6990
authors.initials: M
authors.lastname: Ismail