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首页> 外文期刊>The American Journal of Cardiology >Comparison of Successful Myocardial Reperfusion and Adverse Events in Patients With ST-Elevation Myocardial Infarction Who Underwent Rescue Percutaneous Coronary Intervention After Failed Fibrinolytic Therapy With Versus Without Manual Coronary Thrombus Aspiration
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Comparison of Successful Myocardial Reperfusion and Adverse Events in Patients With ST-Elevation Myocardial Infarction Who Underwent Rescue Percutaneous Coronary Intervention After Failed Fibrinolytic Therapy With Versus Without Manual Coronary Thrombus Aspiration

机译：ST抬高型心肌梗死行纤溶治疗失败后行经皮冠状动脉介入治疗但未进行人工冠状动脉抽吸术的患者成功心肌再灌注和不良事件的比较

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It has been unclear the impact of manual thrombus aspiration (TA) on procedural outcomes in patients with ST-elevation myocardial infarction (STEMI) who underwent rescue percutaneous coronary intervention (PCI) after failed fibrinolytic therapy in comparison with primary PCI. Our aim was to test the hypothesis that manual TA may improve myocardial reperfusion and clinical outcomes in patients with STEMI who underwent rescue PCI after failed fibrinolytic therapy. From March 2011 to March 2014, 70 patients with STEMI after unsuccessful fibrinolysis were randomized to either rescue PCI with TA (TA group) or without TA (NTA group). Primary end points were rate of myocardial blush grade >= 2 and ST-segment resolution >= 70%. The secondary end point included 30 days follow-up for major adverse cardiac events (MACEs). Baseline clinical and angiographic characteristics were similar in the >= 2 groups. The TA and NTA groups were compared as follows: myocardial blush grade 71% versus 46% (p <0.05); complete ST-segment resolution 71% versus 46% (p <0.05); no reflow 20% versus 49% (p <0.05); procedure time (min) 65.0 +/- 38.6 versus 90.1 +/- 28.8 (p <0.05); contrast amount (ml) 99.0 +/- 45.2 versus 121.2 +/- 33.4 (p <0.05); and direct stenting 60% versus 37% (p <0.05). There was a significant reduction of MACE in the TA group, 20%sersus 37% (p <0.05). In conclusion, rescue PCI with manual TA leads to better myocardial reperfusion and significant reduction of MACE. (C) 2015 Elsevier Inc. All rights reserved.
机译：与原发性PCI相比，在纤溶治疗失败后接受急诊经皮冠状动脉介入治疗（PCI）的ST段抬高型心肌梗死（STEMI）患者中，手动血栓抽吸（TA）对手术结局的影响尚不清楚。我们的目的是检验以下假设：在纤溶治疗失败后接受抢救PCI的STEMI患者中，手动TA可以改善心肌再灌注和临床结局。从2011年3月至2014年3月，将70例纤维蛋白溶解失败后的STEMI患者随机分为接受TA的PCI（TA组）或不接受TA（NTA组）的PCI抢救。主要终点为心肌腮红等级> = 2和ST段分辨率> = 70％。次要终点包括重大不良心脏事件（MACE）的30天随访。 > = 2组的基线临床和血管造影特征相似。 TA和NTA组的比较如下：心肌腮红等级为71％vs 46％（p <0.05）; ST段的完整分辨率为71％对46％（p <0.05）;无回流20％对49％（p <0.05）;手术时间（分钟）65.0 +/- 38.6与90.1 +/- 28.8（p <0.05）;对比量（ml）99.0 +/- 45.2与121.2 +/- 33.4（p <0.05）;和直接支架置入术分别为60％和37％（p <0.05）。 TA组的MACE显着降低，20％达37％（p <0.05）。总之，采用手动TA进行抢救PCI可以改善心肌的再灌注，并显着降低MACE。 （C）2015 Elsevier Inc.保留所有权利。

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