Thrombus aspiration during primary angioplasty for cardiogenic shock

• Published in: International journal of cardiology Vol. 140; no. 1; pp. 111 - 113
• Main Authors: Rigattieri, Stefano, Di Russo, Cristian, Musto, Carmine, Schirripa, Valentina, Silvestri, Pasquale, Biondi-Zoccai, Giuseppe, Ferraiuolo, Giuseppe, Loschiavo, Paolo
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 01.04.2010; Elsevier
• Subjects: Aged; Aged, 80 and over; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Angioplasty, Balloon, Coronary; Biological and medical sciences; Cardiogenic shock; Cardiology. Vascular system; Cardiovascular; Coronary heart disease; Coronary Thrombosis - complications; Coronary Thrombosis - surgery; Diseases of the cardiovascular system; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care; Female; Heart; Hospital Mortality; Humans; Intensive care medicine; Logistic Models; Male; Medical sciences; Middle Aged; Myocardial infarction; Myocardial Infarction - complications; Myocardial Infarction - mortality; Myocarditis. Cardiomyopathies; Primary angioplasty; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Retrospective Studies; Shock, Cardiogenic - complications; Shock, Cardiogenic - mortality; Shock, Cardiogenic - therapy; Thrombectomy; Myocardial infarction; Thrombectomy; Primary angioplasty; Cardiogenic shock; Angioplasty; Aspiration; Thrombus; Instrumentation therapy; Cardiovascular disease; Instrumental dilatation; Coronary heart disease; Myocardial disease; Primary; Cardiology
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2008.10.038

Abstract We sought to assess the clinical efficacy of thrombus aspiration during primary percutaneous coronary interventions (PCI) in patients presenting with ST-elevation myocardial infarction (STEMI) complicated by cardiogenic shock (CS). We retrospectively selected 44 patients with CS out of a population of 842 STEMI patients treated with primary PCI at our Hospital between March 2003 and October 2007. Twenty-six patients died during hospital stay (59.1%, Group 1), whereas the remaining 18 were discharged (40.9%, Group 2). Post-procedural ST-segment resolution was greater (68.0% ± 35.6 vs. 43.0% ± 35.0; p = 0.06) and in-hospital mortality was significantly lower (21.4% vs 76.6%; p < 0.01) in patients treated by TA as compared to patients undergoing standard PCI. At multivariate logistic regression analysis, TA was the only variable independently associated with survival.