PT  - JOURNAL ARTICLE
AU  - L De Luca
AU  - G Sardella
AU  - C J Davidson
AU  - G De Persio
AU  - M Beraldi
AU  - T Tommasone
AU  - M Mancone
AU  - B L Nguyen
AU  - L Agati
AU  - M Gheorghiade
AU  - F Fedele
TI  - Impact of intracoronary aspiration thrombectomy during primary angioplasty on left ventricular remodelling in patients with anterior ST elevation myocardial infarction
AID  - 10.1136/hrt.2005.074716
DP  - 2006 Jul 01
TA  - Heart
PG  - 951--957
VI  - 92
IP  - 7
4099  - http://heart.bmj.com/content/92/7/951.short
4100  - http://heart.bmj.com/content/92/7/951.full
SO  - Heart2006 Jul 01; 92
AB  - Objective: To evaluate prospectively the impact on left ventricular (LV) remodelling of an intracoronary aspiration thrombectomy device as adjunctive therapy in primary percutaneous coronary intervention (PCI) in patients with anterior ST elevation myocardial infarction (STEMI). Methods: 76 consecutive patients with anterior STEMI (65.3 (11.2) years, 48 men) were randomly assigned to intracoronary thrombectomy and stent placement (n  =  38) or to conventional stenting (n  =  38) of the infarct related artery. Each patient underwent transthoracic echocardiography immediately after PCI and at six months. At the time of echocardiographic control, major adverse cardiovascular events (MACE) in terms of death, new onset of myocardial infarction, and hospitalisation for heart failure were also evaluated. Results: After a successful primary PCI, patients in the thrombectomy group achieved a higher rate of post-procedure myocardial blush grade 3 (36.8% v 13.1%, p  =  0.03) and effective ST segment resolution at 90 minutes (81.6% v 55.3%, p  =  0.02). Six months after the index intervention, 19 patients (26.8%) developed LV dilatation, defined as an increase in end diastolic volume (EDV) ⩾ 20%: 15 in the conventional group and four in the thrombectomy group (p  =  0.006). Accordingly, at six months patients treated conventionally had significantly higher end systolic volumes (82 (7.7) ml v 75.3 (4.9) ml, p < 0.0001) and EDV (152.5 (18.1) ml v 138.1 (10.7) ml, p < 0.0001) than patients treated with thrombectomy. No differences in cumulative MACE were observed (10.5% in the conventional group v 8.6% in the thrombectomy group, not significant). Conclusion: Compared with conventional stenting, adjunctive aspiration thrombectomy in successful primary PCI seems to be associated with a significantly lower incidence of LV remodelling at six months in patients with anterior STEMI.