Safety and feasibility of a PAclitaxel-eluting balloon angioplasty in Primary Percutaneous coronary intervention in Amsterdam (PAPPA): one-year clinical outcome of a pilot study

2014 ◽  
Vol 10 (5) ◽  
pp. 584-590 ◽  
Author(s):  
Nicola S. Vos ◽  
Maurits T. Dirksen ◽  
Maarten A. Vink ◽  
Ferdinand C. van Nooijen ◽  
Giovanni Amoroso ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Pilot Study ◽  
Clinical Outcome ◽  
Primary Percutaneous Coronary Intervention ◽  
Balloon Angioplasty ◽  
Coronary Intervention ◽  
Percutaneous Coronary ◽  
One Year

The effect of thrombus aspiration during primary percutaneous coronary intervention on clinical outcome in daily clinical practice

2014 ◽  
Vol 111 (01) ◽  
pp. 165-171 ◽  
Author(s):  
Sinem Kilic ◽  
Jan Paul Ottervanger ◽  
Jan-Henk E. Dambrink ◽  
Jan C. A. Hoorntje ◽  
Petra C. Koopmans ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Clinical Outcome ◽  
Primary Percutaneous Coronary Intervention ◽  
Real World ◽  
Coronary Intervention ◽  
Cardiac Mortality ◽  
Thrombus Aspiration ◽  
End Points ◽  
Percutaneous Coronary ◽  
One Year

SummaryIt was the purpose of this study to assess the effect of thrombus aspiration (TA) during primary percutaneous coronary intervention (PPCI) on reperfusion and clinical outcome in a real-world STEMI population. The decision to use TA (Export catheter, Medtronic) was at the discretion of the treating cardiologist. The primary endpoint was mortality at short (in-hospital) and long term (one year) follow-up. Secondary end points were post-PCI TIMI flow, residual ST deviation and enzymatic infarct size. Cox proportional hazard models (propensity-weighted) and logistic regression analysis were used to adjust for known covariates, associated with mortality. We performed a retrospective analysis of prospectively collected data on 2,552 consecutive PPCI-treated STEMI patients between 2007 and 2010. Use of TA increased from 6.9% in 2007 to 62.2% in 2010 (p<0.001). TA was performed in 899 patients (35.2%). In-hospital and one-year mortality rates were 3.0% and 6.0%, respectively, in the TA group and 3.5% and 7.6% in the no- TA group. After multivariate analysis, TA was not significantly associated with in-hospital mortality (adjusted odds ratio [OR]: 0.70; 95% confidence interval [CI]: 0.33–1.49, p=0.36) nor one year mortality (adjusted hazard ratio [HR]: 0.75, 95%CI: 0.47–1.20, p=0.23) or cardiac mortality (HR: 0.81; 95%CI: 0.45–1.46, p=0.49). After matching on the propensity score, the HR in the TA group for one year mortality was 0.70 (95%CI: 0.41–1.20, p=0.19) and for one-year cardiac mortality 0.70 (95%CI: 0.36–1.34, p=0.28). In conclusion, no significant relationship of TA with one of the secondary end points was found. The use of TA increased over the last years but clinical outcome was similar in both groups (TA vs no-TA) in this large cohort of real-world, unselected STEMI patients.

scholarly journals Clinical outcome following late reperfusion with percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction

2020 ◽  
pp. 204887261988631
Author(s):  
Lars Nepper-Christensen ◽  
Jacob Lønborg ◽  
Dan Eik Høfsten ◽  
Golnaz Sadjadieh ◽  
Mikkel Malby Schoos ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Clinical Outcome ◽  
Primary Percutaneous Coronary Intervention ◽  
Symptom Onset ◽  
Coronary Intervention ◽  
Adverse Clinical Outcome ◽  
St Segment Elevation ◽  
St Segment ◽  
Increased Risk ◽  
Percutaneous Coronary

Background: Up to 40% of patients with ST-segment elevation myocardial infarction (STEMI) present later than 12 hours after symptom onset. However, data on clinical outcomes in STEMI patients treated with primary percutaneous coronary intervention 12 or more hours after symptom onset are non-existent. We evaluated the association between primary percutaneous coronary intervention performed later than 12 hours after symptom onset and clinical outcomes in a large all-comer contemporary STEMI cohort. Methods: All STEMI patients treated with primary percutaneous coronary intervention in eastern Denmark from November 2009 to November 2016 were included and stratified by timing of the percutaneous coronary intervention. The combined clinical endpoint of all-cause mortality and hospitalisation for heart failure was identified from nationwide Danish registries. Results: We included 6674 patients: 6108 (92%) were treated less than 12 hours and 566 (8%) were treated 12 or more hours after symptom onset. During a median follow-up period of 3.8 (interquartile range 2.3–5.6) years, 30-day, one-year and long-term cumulative rates of the combined endpoint were 11%, 17% and 25% in patients treated 12 or fewer hours and 21%, 29% and 37% in patients treated more than 12 hours ( P<0.001 for all) after symptom onset. Late presentation was independently associated with an increased risk of an adverse clinical outcome (hazard ratio 1.42, 95% confidence interval 1.22–1.66; P<0.001). Conclusions: Increasing duration from symptom onset to primary percutaneous coronary intervention was associated with an increased risk of an adverse clinical outcome in patients with STEMI, especially when the delay exceeded 12 hours.

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