[Influences of different aspiration results by aspiration thrombectomy catheter in emergent percutaneous coronary intervention for patents with acute myocardial infarction].

OBJECTIVE

To evaluate the influences of different aspiration results by Diver C.E. aspiration thrombectomy catheter on myocardium perfusion and clinical outcomes during emergency PCI (percutaneous coronary intervention) for the patients with acute ST segment elevation myocardial infarction (STEMI).

METHODS

The patients undergoing emergent PCI and using Diver C.E. aspiration thrombectomy catheter with STEMI from July 2008 to February 2011 were enrolled into the study group. According to the aspiration results, they were divided into 2 groups: aspiration-positive group (n = 38) and aspiration-negative group (n = 28). And those undergoing routine PCI alone during the same period were enrolled into the control group (n = 66). The baseline profiles, immediate post-operative CAG (coronary angiography) and follow-up data were compared.

RESULTS

No significant baseline differences existed among 3 groups. Compared with the control group, all parameters significantly improved in the aspiration-positive group. But in the aspiration-negative group, the differences of slow flow/no-reflow and major adverse cardiovascular events (MACE) were insignificant (P > 0.05). Compared with the aspiration-negative group, cTFC (29 ± 9 vs 35 ± 11 frames, P < 0.05), ST segment (90% ± 20% vs 76% ± 25%, P < 0.05) and the peak serum levels of CK-MB (creatine kinase-MB) and TnT (troponin-T) [CK-MB: (201 ± 86) U/L vs (264 ± 93) U/L, P < 0.05; TnT: (41 ± 21) µg/L vs (60 ± 24) µg/L, P < 0.05] decreased significantly. But the differences in slow flow/no-reflow and MACE were insignificant (P > 0.05).

CONCLUSION

Application of Diver CE. during emergent PCI i.s both safe and efficacious for STEMI patients with heavier thrombus burden. It may improve distal myocardium perfusion and abate myocardial damage. The patients with positive aspiration results have better clinical outcome. But the efficacy of aspiration-negative patients needs further evaluations.