Thrombus aspiration followed by direct stenting: A novel strategy of primary percutaneous coronary intervention in ST-segment elevation myocardial infarction. Results of the Polish-Italian-Hungarian RAndomized ThrombEctomy Trial (PIHRATE Trial)
Background Previous studies with thrombectomy showed different results, mainly due to use of thrombectomy as an additional device not instead of balloon predilatation. The aim of the present study was to assess impact of aspiration thrombectomy followed by direct stenting. Methods Patients with ST e...
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| Veröffentlicht in: | The American heart journal 2010-11, Vol.160 (5), p.966-972 |
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| creator | Dudek, Dariusz, MD, PhD Mielecki, Waldemar, MD Burzotta, Francesco, MD, PhD Gasior, Mariusz, MD, PhD Witkowski, Adam, MD, PhD Horvath, Ivan G., MD, PhD Legutko, Jacek, MD, PhD Ochala, Andrzej, MD, PhD Rubartelli, Paolo, MD Wojdyla, Roman M., MD Siudak, Zbigniew, MD, PhD Buchta, Piotr, MD Pregowski, Jerzy, MD Aradi, Daniel, MD Machnik, Andrzej, MD Hawranek, Michal, MD Rakowski, Tomasz, MD, PhD Dziewierz, Artur, MD, PhD Zmudka, Krzysztof, MD, PhD |
| description | Background Previous studies with thrombectomy showed different results, mainly due to use of thrombectomy as an additional device not instead of balloon predilatation. The aim of the present study was to assess impact of aspiration thrombectomy followed by direct stenting. Methods Patients with ST elevation myocardial infarction (STEMI) 70% (STR > 70%) 60 minutes after primary angioplasty (percutaneous coronary intervention [PCI]). Secondary end points included angiographic myocardial blush grade (MBG) after PCI, combination of STR > 70% immediately after PCI and MBG grade 3 (optimal myocardial reperfusion), Thrombolysis In Myocardial Infarction flow after PCI, angiographic complications, and in-hospital major adverse cardiac events. Results Aspiration thrombectomy success rate was 91% (crossing of the lesion with thrombus reduction and flow restoration). There was no significant difference in STR ≥ 70% after 60 minutes (53.7% vs 35.1%, P = .29). STR > 70% immediately after PCI (41% vs 26%, P < .05), MBG grade 3 (76% vs 58%, P < .03), and optimal myocardial reperfusion (35.1% vs 11.8%, P < .001) were more frequent in TS. There was no difference in between the groups in 6-month mortality (4% vs 3.1%, P = .74) and reinfarction rate (1% vs 3.1%, P = .29). Conclusions Aspiration thrombectomy and direct stenting is safe and effective in STEMI patients with early presentation ( |
| doi_str_mv | 10.1016/j.ahj.2010.07.024 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_812126995</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S0002870310006678</els_id><sourcerecordid>3238416331</sourcerecordid><originalsourceid>FETCH-LOGICAL-c531t-62a021fa30140b8542b5f254121f90f1e89162080dd583c30e2d2bd8f835885b3</originalsourceid><addsrcrecordid>eNp9kt-K1DAUxoso7rj6AN5IQES96Jik_1IFYVhGZ2DBZXa8Dml6OpMxTWaTdqQ-tw9gSkcX9sKr9nz8zndODl8UvSR4TjDJPxzmYn-YUxxqXMwxTR9FM4LLIs6LNH0czTDGNGYFTi6iZ94fQplTlj-NLmigMsqKWfR7u3e2rXqPhD8qJzplDWqs1vYn1KgaUK0cyA75DkynzO4jWiBjT6CDEmjYDcg26OhUK9yAjuBk3wkDNhhK66wZVWU6cKexP3grg263sYddGwQEGk7TzHawUrhaCR2QRjg5qnO0Ad_rzo9Duj2gG6uV38frTmglTLzqzU648Ic2C1PbVv0KS08vWsrOtgPautHx3c16tVlsl1P5_nn0pBHaw4vz9zL6_mW5vVrF19--rq8W17HMEtLFORWYkkYkmKS4YllKq6yhWUqCWOKGACtJTjHDdZ2xRCYYaE2rmjUsyRjLquQyejv5Hp2968F3vFVegtbThTgLTjQvyyyQrx-QB9s7E5bjJMNpnpR5SQNFJko6672Dhp8PzwnmYyL4gYdE8DERHBc8JCL0vDo791UL9b-OvxEIwJszILwUunHCSOXvuSSnaZGMRp8mDsLFTgoc91KBkTAlhNdW_XeNzw-6pVZGhYE_YAB__1ruKcf8dozumFwyhjYvWPIHU9nsYw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1504639692</pqid></control><display><type>article</type><title>Thrombus aspiration followed by direct stenting: A novel strategy of primary percutaneous coronary intervention in ST-segment elevation myocardial infarction. Results of the Polish-Italian-Hungarian RAndomized ThrombEctomy Trial (PIHRATE Trial)</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Dudek, Dariusz, MD, PhD ; Mielecki, Waldemar, MD ; Burzotta, Francesco, MD, PhD ; Gasior, Mariusz, MD, PhD ; Witkowski, Adam, MD, PhD ; Horvath, Ivan G., MD, PhD ; Legutko, Jacek, MD, PhD ; Ochala, Andrzej, MD, PhD ; Rubartelli, Paolo, MD ; Wojdyla, Roman M., MD ; Siudak, Zbigniew, MD, PhD ; Buchta, Piotr, MD ; Pregowski, Jerzy, MD ; Aradi, Daniel, MD ; Machnik, Andrzej, MD ; Hawranek, Michal, MD ; Rakowski, Tomasz, MD, PhD ; Dziewierz, Artur, MD, PhD ; Zmudka, Krzysztof, MD, PhD</creator><creatorcontrib>Dudek, Dariusz, MD, PhD ; Mielecki, Waldemar, MD ; Burzotta, Francesco, MD, PhD ; Gasior, Mariusz, MD, PhD ; Witkowski, Adam, MD, PhD ; Horvath, Ivan G., MD, PhD ; Legutko, Jacek, MD, PhD ; Ochala, Andrzej, MD, PhD ; Rubartelli, Paolo, MD ; Wojdyla, Roman M., MD ; Siudak, Zbigniew, MD, PhD ; Buchta, Piotr, MD ; Pregowski, Jerzy, MD ; Aradi, Daniel, MD ; Machnik, Andrzej, MD ; Hawranek, Michal, MD ; Rakowski, Tomasz, MD, PhD ; Dziewierz, Artur, MD, PhD ; Zmudka, Krzysztof, MD, PhD</creatorcontrib><description>Background Previous studies with thrombectomy showed different results, mainly due to use of thrombectomy as an additional device not instead of balloon predilatation. The aim of the present study was to assess impact of aspiration thrombectomy followed by direct stenting. Methods Patients with ST elevation myocardial infarction (STEMI) <6 hours from pain onset and occluded infarct-related artery in baseline angiography were randomized into aspiration thrombectomy followed by direct stenting (TS, n = 100) or standard balloon predilatation followed by stent implantation (n = 96). The primary end point of the study was the electrocardiographic ST-segment elevation resolution >70% (STR > 70%) 60 minutes after primary angioplasty (percutaneous coronary intervention [PCI]). Secondary end points included angiographic myocardial blush grade (MBG) after PCI, combination of STR > 70% immediately after PCI and MBG grade 3 (optimal myocardial reperfusion), Thrombolysis In Myocardial Infarction flow after PCI, angiographic complications, and in-hospital major adverse cardiac events. Results Aspiration thrombectomy success rate was 91% (crossing of the lesion with thrombus reduction and flow restoration). There was no significant difference in STR ≥ 70% after 60 minutes (53.7% vs 35.1%, P = .29). STR > 70% immediately after PCI (41% vs 26%, P < .05), MBG grade 3 (76% vs 58%, P < .03), and optimal myocardial reperfusion (35.1% vs 11.8%, P < .001) were more frequent in TS. There was no difference in between the groups in 6-month mortality (4% vs 3.1%, P = .74) and reinfarction rate (1% vs 3.1%, P = .29). Conclusions Aspiration thrombectomy and direct stenting is safe and effective in STEMI patients with early presentation (<6 hours). The angiographic parameters of microcirculation reperfusion and ECG ST-segment resolution directly after PCI were significantly better in thrombectomy group despite the lack of the difference in ST-segment resolution 60 minutes after PCI.</description><identifier>ISSN: 0002-8703</identifier><identifier>EISSN: 1097-6744</identifier><identifier>DOI: 10.1016/j.ahj.2010.07.024</identifier><identifier>PMID: 21095287</identifier><identifier>CODEN: AHJOA2</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Angioplasty, Balloon, Coronary - methods ; Biological and medical sciences ; Blood clots ; Blood pressure ; Cardiology. Vascular system ; Cardiovascular ; Coronary Angiography ; Coronary heart disease ; Coronary Thrombosis - complications ; Coronary Thrombosis - surgery ; Coronary vessels ; Diseases of the cardiovascular system ; Electrocardiography ; Female ; Follow-Up Studies ; Heart ; Heart attacks ; Humans ; Hungary ; Intubation ; Italy ; Male ; Medical imaging ; Medical sciences ; Middle Aged ; Mortality ; Myocardial Infarction - etiology ; Myocardial Infarction - physiopathology ; Myocardial Infarction - therapy ; Myocarditis. Cardiomyopathies ; Poland ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Retrospective Studies ; Stents ; Suction - methods ; Thrombectomy - methods ; Time Factors ; Treatment Outcome ; Veins & arteries</subject><ispartof>The American heart journal, 2010-11, Vol.160 (5), p.966-972</ispartof><rights>Mosby, Inc.</rights><rights>2010 Mosby, Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2010 Mosby, Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Nov 2010</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c531t-62a021fa30140b8542b5f254121f90f1e89162080dd583c30e2d2bd8f835885b3</citedby><cites>FETCH-LOGICAL-c531t-62a021fa30140b8542b5f254121f90f1e89162080dd583c30e2d2bd8f835885b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002870310006678$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23624734$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21095287$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dudek, Dariusz, MD, PhD</creatorcontrib><creatorcontrib>Mielecki, Waldemar, MD</creatorcontrib><creatorcontrib>Burzotta, Francesco, MD, PhD</creatorcontrib><creatorcontrib>Gasior, Mariusz, MD, PhD</creatorcontrib><creatorcontrib>Witkowski, Adam, MD, PhD</creatorcontrib><creatorcontrib>Horvath, Ivan G., MD, PhD</creatorcontrib><creatorcontrib>Legutko, Jacek, MD, PhD</creatorcontrib><creatorcontrib>Ochala, Andrzej, MD, PhD</creatorcontrib><creatorcontrib>Rubartelli, Paolo, MD</creatorcontrib><creatorcontrib>Wojdyla, Roman M., MD</creatorcontrib><creatorcontrib>Siudak, Zbigniew, MD, PhD</creatorcontrib><creatorcontrib>Buchta, Piotr, MD</creatorcontrib><creatorcontrib>Pregowski, Jerzy, MD</creatorcontrib><creatorcontrib>Aradi, Daniel, MD</creatorcontrib><creatorcontrib>Machnik, Andrzej, MD</creatorcontrib><creatorcontrib>Hawranek, Michal, MD</creatorcontrib><creatorcontrib>Rakowski, Tomasz, MD, PhD</creatorcontrib><creatorcontrib>Dziewierz, Artur, MD, PhD</creatorcontrib><creatorcontrib>Zmudka, Krzysztof, MD, PhD</creatorcontrib><title>Thrombus aspiration followed by direct stenting: A novel strategy of primary percutaneous coronary intervention in ST-segment elevation myocardial infarction. Results of the Polish-Italian-Hungarian RAndomized ThrombEctomy Trial (PIHRATE Trial)</title><title>The American heart journal</title><addtitle>Am Heart J</addtitle><description>Background Previous studies with thrombectomy showed different results, mainly due to use of thrombectomy as an additional device not instead of balloon predilatation. The aim of the present study was to assess impact of aspiration thrombectomy followed by direct stenting. Methods Patients with ST elevation myocardial infarction (STEMI) <6 hours from pain onset and occluded infarct-related artery in baseline angiography were randomized into aspiration thrombectomy followed by direct stenting (TS, n = 100) or standard balloon predilatation followed by stent implantation (n = 96). The primary end point of the study was the electrocardiographic ST-segment elevation resolution >70% (STR > 70%) 60 minutes after primary angioplasty (percutaneous coronary intervention [PCI]). Secondary end points included angiographic myocardial blush grade (MBG) after PCI, combination of STR > 70% immediately after PCI and MBG grade 3 (optimal myocardial reperfusion), Thrombolysis In Myocardial Infarction flow after PCI, angiographic complications, and in-hospital major adverse cardiac events. Results Aspiration thrombectomy success rate was 91% (crossing of the lesion with thrombus reduction and flow restoration). There was no significant difference in STR ≥ 70% after 60 minutes (53.7% vs 35.1%, P = .29). STR > 70% immediately after PCI (41% vs 26%, P < .05), MBG grade 3 (76% vs 58%, P < .03), and optimal myocardial reperfusion (35.1% vs 11.8%, P < .001) were more frequent in TS. There was no difference in between the groups in 6-month mortality (4% vs 3.1%, P = .74) and reinfarction rate (1% vs 3.1%, P = .29). Conclusions Aspiration thrombectomy and direct stenting is safe and effective in STEMI patients with early presentation (<6 hours). The angiographic parameters of microcirculation reperfusion and ECG ST-segment resolution directly after PCI were significantly better in thrombectomy group despite the lack of the difference in ST-segment resolution 60 minutes after PCI.</description><subject>Angioplasty, Balloon, Coronary - methods</subject><subject>Biological and medical sciences</subject><subject>Blood clots</subject><subject>Blood pressure</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular</subject><subject>Coronary Angiography</subject><subject>Coronary heart disease</subject><subject>Coronary Thrombosis - complications</subject><subject>Coronary Thrombosis - surgery</subject><subject>Coronary vessels</subject><subject>Diseases of the cardiovascular system</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart</subject><subject>Heart attacks</subject><subject>Humans</subject><subject>Hungary</subject><subject>Intubation</subject><subject>Italy</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Myocardial Infarction - etiology</subject><subject>Myocardial Infarction - physiopathology</subject><subject>Myocardial Infarction - therapy</subject><subject>Myocarditis. Cardiomyopathies</subject><subject>Poland</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>Retrospective Studies</subject><subject>Stents</subject><subject>Suction - methods</subject><subject>Thrombectomy - methods</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Veins & arteries</subject><issn>0002-8703</issn><issn>1097-6744</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kt-K1DAUxoso7rj6AN5IQES96Jik_1IFYVhGZ2DBZXa8Dml6OpMxTWaTdqQ-tw9gSkcX9sKr9nz8zndODl8UvSR4TjDJPxzmYn-YUxxqXMwxTR9FM4LLIs6LNH0czTDGNGYFTi6iZ94fQplTlj-NLmigMsqKWfR7u3e2rXqPhD8qJzplDWqs1vYn1KgaUK0cyA75DkynzO4jWiBjT6CDEmjYDcg26OhUK9yAjuBk3wkDNhhK66wZVWU6cKexP3grg263sYddGwQEGk7TzHawUrhaCR2QRjg5qnO0Ad_rzo9Duj2gG6uV38frTmglTLzqzU648Ic2C1PbVv0KS08vWsrOtgPautHx3c16tVlsl1P5_nn0pBHaw4vz9zL6_mW5vVrF19--rq8W17HMEtLFORWYkkYkmKS4YllKq6yhWUqCWOKGACtJTjHDdZ2xRCYYaE2rmjUsyRjLquQyejv5Hp2968F3vFVegtbThTgLTjQvyyyQrx-QB9s7E5bjJMNpnpR5SQNFJko6672Dhp8PzwnmYyL4gYdE8DERHBc8JCL0vDo791UL9b-OvxEIwJszILwUunHCSOXvuSSnaZGMRp8mDsLFTgoc91KBkTAlhNdW_XeNzw-6pVZGhYE_YAB__1ruKcf8dozumFwyhjYvWPIHU9nsYw</recordid><startdate>20101101</startdate><enddate>20101101</enddate><creator>Dudek, Dariusz, MD, PhD</creator><creator>Mielecki, Waldemar, MD</creator><creator>Burzotta, Francesco, MD, PhD</creator><creator>Gasior, Mariusz, MD, PhD</creator><creator>Witkowski, Adam, MD, PhD</creator><creator>Horvath, Ivan G., MD, PhD</creator><creator>Legutko, Jacek, MD, PhD</creator><creator>Ochala, Andrzej, MD, PhD</creator><creator>Rubartelli, Paolo, MD</creator><creator>Wojdyla, Roman M., MD</creator><creator>Siudak, Zbigniew, MD, PhD</creator><creator>Buchta, Piotr, MD</creator><creator>Pregowski, Jerzy, MD</creator><creator>Aradi, Daniel, MD</creator><creator>Machnik, Andrzej, MD</creator><creator>Hawranek, Michal, MD</creator><creator>Rakowski, Tomasz, MD, PhD</creator><creator>Dziewierz, Artur, MD, PhD</creator><creator>Zmudka, Krzysztof, MD, PhD</creator><general>Mosby, Inc</general><general>Mosby</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20101101</creationdate><title>Thrombus aspiration followed by direct stenting: A novel strategy of primary percutaneous coronary intervention in ST-segment elevation myocardial infarction. Results of the Polish-Italian-Hungarian RAndomized ThrombEctomy Trial (PIHRATE Trial)</title><author>Dudek, Dariusz, MD, PhD ; Mielecki, Waldemar, MD ; Burzotta, Francesco, MD, PhD ; Gasior, Mariusz, MD, PhD ; Witkowski, Adam, MD, PhD ; Horvath, Ivan G., MD, PhD ; Legutko, Jacek, MD, PhD ; Ochala, Andrzej, MD, PhD ; Rubartelli, Paolo, MD ; Wojdyla, Roman M., MD ; Siudak, Zbigniew, MD, PhD ; Buchta, Piotr, MD ; Pregowski, Jerzy, MD ; Aradi, Daniel, MD ; Machnik, Andrzej, MD ; Hawranek, Michal, MD ; Rakowski, Tomasz, MD, PhD ; Dziewierz, Artur, MD, PhD ; Zmudka, Krzysztof, MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c531t-62a021fa30140b8542b5f254121f90f1e89162080dd583c30e2d2bd8f835885b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Angioplasty, Balloon, Coronary - methods</topic><topic>Biological and medical sciences</topic><topic>Blood clots</topic><topic>Blood pressure</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular</topic><topic>Coronary Angiography</topic><topic>Coronary heart disease</topic><topic>Coronary Thrombosis - complications</topic><topic>Coronary Thrombosis - surgery</topic><topic>Coronary vessels</topic><topic>Diseases of the cardiovascular system</topic><topic>Electrocardiography</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart</topic><topic>Heart attacks</topic><topic>Humans</topic><topic>Hungary</topic><topic>Intubation</topic><topic>Italy</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Myocardial Infarction - etiology</topic><topic>Myocardial Infarction - physiopathology</topic><topic>Myocardial Infarction - therapy</topic><topic>Myocarditis. Cardiomyopathies</topic><topic>Poland</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><topic>Retrospective Studies</topic><topic>Stents</topic><topic>Suction - methods</topic><topic>Thrombectomy - methods</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dudek, Dariusz, MD, PhD</creatorcontrib><creatorcontrib>Mielecki, Waldemar, MD</creatorcontrib><creatorcontrib>Burzotta, Francesco, MD, PhD</creatorcontrib><creatorcontrib>Gasior, Mariusz, MD, PhD</creatorcontrib><creatorcontrib>Witkowski, Adam, MD, PhD</creatorcontrib><creatorcontrib>Horvath, Ivan G., MD, PhD</creatorcontrib><creatorcontrib>Legutko, Jacek, MD, PhD</creatorcontrib><creatorcontrib>Ochala, Andrzej, MD, PhD</creatorcontrib><creatorcontrib>Rubartelli, Paolo, MD</creatorcontrib><creatorcontrib>Wojdyla, Roman M., MD</creatorcontrib><creatorcontrib>Siudak, Zbigniew, MD, PhD</creatorcontrib><creatorcontrib>Buchta, Piotr, MD</creatorcontrib><creatorcontrib>Pregowski, Jerzy, MD</creatorcontrib><creatorcontrib>Aradi, Daniel, MD</creatorcontrib><creatorcontrib>Machnik, Andrzej, MD</creatorcontrib><creatorcontrib>Hawranek, Michal, MD</creatorcontrib><creatorcontrib>Rakowski, Tomasz, MD, PhD</creatorcontrib><creatorcontrib>Dziewierz, Artur, MD, PhD</creatorcontrib><creatorcontrib>Zmudka, Krzysztof, MD, PhD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dudek, Dariusz, MD, PhD</au><au>Mielecki, Waldemar, MD</au><au>Burzotta, Francesco, MD, PhD</au><au>Gasior, Mariusz, MD, PhD</au><au>Witkowski, Adam, MD, PhD</au><au>Horvath, Ivan G., MD, PhD</au><au>Legutko, Jacek, MD, PhD</au><au>Ochala, Andrzej, MD, PhD</au><au>Rubartelli, Paolo, MD</au><au>Wojdyla, Roman M., MD</au><au>Siudak, Zbigniew, MD, PhD</au><au>Buchta, Piotr, MD</au><au>Pregowski, Jerzy, MD</au><au>Aradi, Daniel, MD</au><au>Machnik, Andrzej, MD</au><au>Hawranek, Michal, MD</au><au>Rakowski, Tomasz, MD, PhD</au><au>Dziewierz, Artur, MD, PhD</au><au>Zmudka, Krzysztof, MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Thrombus aspiration followed by direct stenting: A novel strategy of primary percutaneous coronary intervention in ST-segment elevation myocardial infarction. Results of the Polish-Italian-Hungarian RAndomized ThrombEctomy Trial (PIHRATE Trial)</atitle><jtitle>The American heart journal</jtitle><addtitle>Am Heart J</addtitle><date>2010-11-01</date><risdate>2010</risdate><volume>160</volume><issue>5</issue><spage>966</spage><epage>972</epage><pages>966-972</pages><issn>0002-8703</issn><eissn>1097-6744</eissn><coden>AHJOA2</coden><abstract>Background Previous studies with thrombectomy showed different results, mainly due to use of thrombectomy as an additional device not instead of balloon predilatation. The aim of the present study was to assess impact of aspiration thrombectomy followed by direct stenting. Methods Patients with ST elevation myocardial infarction (STEMI) <6 hours from pain onset and occluded infarct-related artery in baseline angiography were randomized into aspiration thrombectomy followed by direct stenting (TS, n = 100) or standard balloon predilatation followed by stent implantation (n = 96). The primary end point of the study was the electrocardiographic ST-segment elevation resolution >70% (STR > 70%) 60 minutes after primary angioplasty (percutaneous coronary intervention [PCI]). Secondary end points included angiographic myocardial blush grade (MBG) after PCI, combination of STR > 70% immediately after PCI and MBG grade 3 (optimal myocardial reperfusion), Thrombolysis In Myocardial Infarction flow after PCI, angiographic complications, and in-hospital major adverse cardiac events. Results Aspiration thrombectomy success rate was 91% (crossing of the lesion with thrombus reduction and flow restoration). There was no significant difference in STR ≥ 70% after 60 minutes (53.7% vs 35.1%, P = .29). STR > 70% immediately after PCI (41% vs 26%, P < .05), MBG grade 3 (76% vs 58%, P < .03), and optimal myocardial reperfusion (35.1% vs 11.8%, P < .001) were more frequent in TS. There was no difference in between the groups in 6-month mortality (4% vs 3.1%, P = .74) and reinfarction rate (1% vs 3.1%, P = .29). Conclusions Aspiration thrombectomy and direct stenting is safe and effective in STEMI patients with early presentation (<6 hours). The angiographic parameters of microcirculation reperfusion and ECG ST-segment resolution directly after PCI were significantly better in thrombectomy group despite the lack of the difference in ST-segment resolution 60 minutes after PCI.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>21095287</pmid><doi>10.1016/j.ahj.2010.07.024</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0002-8703 |
| ispartof | The American heart journal, 2010-11, Vol.160 (5), p.966-972 |
| issn | 0002-8703 1097-6744 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_812126995 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Angioplasty, Balloon, Coronary - methods Biological and medical sciences Blood clots Blood pressure Cardiology. Vascular system Cardiovascular Coronary Angiography Coronary heart disease Coronary Thrombosis - complications Coronary Thrombosis - surgery Coronary vessels Diseases of the cardiovascular system Electrocardiography Female Follow-Up Studies Heart Heart attacks Humans Hungary Intubation Italy Male Medical imaging Medical sciences Middle Aged Mortality Myocardial Infarction - etiology Myocardial Infarction - physiopathology Myocardial Infarction - therapy Myocarditis. Cardiomyopathies Poland Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Retrospective Studies Stents Suction - methods Thrombectomy - methods Time Factors Treatment Outcome Veins & arteries |
| title | Thrombus aspiration followed by direct stenting: A novel strategy of primary percutaneous coronary intervention in ST-segment elevation myocardial infarction. Results of the Polish-Italian-Hungarian RAndomized ThrombEctomy Trial (PIHRATE Trial) |
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