[Manual thrombus aspiration with the Export catheter during primary and rescue angioplasty. Predictors of failed myocardial reperfusion].

Le résumé fourni par la source

BACKGROUND: Manual thrombus aspiration seems to improve myocardial reperfusion after coronary angioplasty in patients with ST-elevation acute coronary syndrome. We sought to assess the independent variables of complete myocardial reperfusion after primary and rescue coronary angioplasty with use of the Export manual thrombus aspiration catheter. METHODS: Myocardial reperfusion were judged complete if ST-segment resolution were >70% at 60 min post-procedure ECG. Sixty-three consecutive patients undergoing primary (81%) or rescue angioplasty (19%) with use of the Export catheter were analyzed. RESULTS: Forty-three (68%) patients had a complete myocardial reperfusion and 20 (32%) patients did not. The independent predictors of failed myocardial reperfusion, at multivariate analysis, were: heart rate at hospital admission (odds ratio [OR] 1.05; 95% confidence interval [CI] 1.01-1.09; p = 0.007), time to angioplasty >3 h (OR 6.07; 95% CI 1.31-27.97; p = 0.005), left anterior descending coronary artery involvement (OR 8.8; 95% CI 2.12-36.4; p = 0.003). CONCLUSIONS: The present study shows that in the setting of primary or rescue angioplasty with use of Export manual thrombus aspiration catheter, patients with high heart rate on admission, an ischemic time >3 h and left anterior descending coronary artery involvement are at higher risk of failed myocardial reperfusion.

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