title: Impact of Distal Protection with Filter-Type Device on Long-term Outcome after Percutaneous Coronary Intervention for Acute Myocardial Infarction: Clinical Results with Filtrap®.
abstract: OBJECTIVE
  Although distal embolization during percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) deteriorates cardiac function, whether distal protection (DP) can improve prognosis is still controversial. We investigated whether a filter-type DP device, Filtrap®, could improve long-term outcomes after PCI for AMI.
  
  
  METHODS
  We studied 164 patients (130 men, mean age: 65.7 years) who underwent PCI. Patients were divided into two groups based on the use of Filtrap®. The occurrence of congestive heart failure (CHF) and major adverse cardiac events (MACE) defined as cardiac death, recurrent AMI, and target vessel revascularization were compared.
  
  
  RESULTS
  Between DP (n=53, 41 men, mean age: 65.5 years) and non-DP (n=111, 89 men, mean age: 65.8 years) groups, although there was significantly greater plaque area in the DP group than in the non-DP group, there were no significant differences in coronary reperfusion flow after PCI. Interestingly, patients with CHF in the non-DP group exhibited a higher CK level than those in the DP group. During a 2-year follow-up period, cumulative CHF was significantly lower in the DP group than in the non-DP group (log-rank p=0.018), and there was no significant difference in the MACE rate (log-rank p=0.238). The use of DP device could not predict MACE, but could predict CHF by multivariate analysis (odds ratio=0.099, 95% CI: 0.02-0.42, p=0.005).
  
  
  CONCLUSIONS
  These results demonstrate that favorable clinical outcomes could be achieved by the filter-type DP device in AMI, particularly in patients with CHF.
authors.affiliation: Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine.
authors.forename: Ryota
authors.initials: R
authors.lastname: Teramoto
authors.forename: Kenji
authors.initials: K
authors.lastname: Sakata
authors.forename: Kenji
authors.initials: K
authors.lastname: Miwa
authors.forename: Takao
authors.initials: T
authors.lastname: Matsubara
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Yasuda
authors.forename: Masaru
authors.initials: M
authors.lastname: Inoue
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Okada
authors.forename: Honin
authors.initials: H
authors.lastname: Kanaya
authors.forename: Masa-Aki
authors.initials: MA
authors.lastname: Kawashiri
authors.forename: Masakazu
authors.initials: M
authors.lastname: Yamagishi
authors.forename: Kenshi
authors.initials: K
authors.lastname: Hayashi
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D004562:Electrocardiography / Q000379:methods; D057505:Embolic Protection Devices / Q000706:statistics & numerical data*; D005260:Female; D005374:Filtration / Q000295:instrumentation*; D006333:Heart Failure / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000601:surgery*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D011379:Prognosis