Shehata Mohamed
Department of Cardiology, Faculty of Medicine, Ain Shams University Hospital, Abbasia Square, P.O. Box 11381, Cairo, Egypt.
Int J Vasc Med. 2014;2014:263926. doi: 10.1155/2014/263926. Epub 2014 Apr 2.
Background. Diabetes mellitus is associated with worse angiographic and clinical outcomes after percutaneous coronary intervention (PCI). Aim. To investigate the impact of manual thrombus aspiration on in-stent restenosis (ISR) and clinical outcome in patients treated by bare-metal stent (BMS) implantation for ST-segment elevation myocardial infarction (STEMI). Methods. 100 diabetic patients were prospectively enrolled. They were randomly assigned to undergo either standard primary PCI (group A, 50 patients) or PCI with thrombus aspiration using Export catheter (group B, 50 patients). The primary endpoint was the rate of eight-month ISR. The secondary endpoint included follow-up for major adverse cardiac events (MACE). Results. Mean age of the study cohort was 59.86 ± 8.3 years, with 64 (64%) being males. Baseline characteristics did not differ between both groups. Eight-month angiogram showed that group B patients had significantly less late lumen loss (0.17 ± 0.35 versus 0.60 ± 0.42 mm, P < 0.001), with lower incidence of ISR (4% versus 16.6%, P < 0.001). There was a trend towards lower rate of MACE in the same group of patients. Conclusion. In diabetic patients undergoing primary PCI, manual thrombus aspiration (compared with standard PCI) was associated with better ISR rate after BMS implantation.
背景。糖尿病与经皮冠状动脉介入治疗（PCI）后血管造影结果和临床结局较差相关。目的。探讨手动血栓抽吸对接受裸金属支架（BMS）植入治疗ST段抬高型心肌梗死（STEMI）患者的支架内再狭窄（ISR）及临床结局的影响。方法。前瞻性纳入100例糖尿病患者。他们被随机分配接受标准直接PCI（A组，50例患者）或使用Export导管进行血栓抽吸的PCI（B组，50例患者）。主要终点是8个月时的ISR发生率。次要终点包括主要不良心脏事件（MACE）的随访情况。结果。研究队列的平均年龄为59.86±8.3岁，男性64例（64%）。两组间基线特征无差异。8个月时的血管造影显示，B组患者的晚期管腔丢失明显较少（0.17±0.35对0.60±0.42mm，P<0.001），ISR发生率较低（4%对16.6%，P<0.001）。同一组患者的MACE发生率有降低趋势。结论。在接受直接PCI的糖尿病患者中，与标准PCI相比，手动血栓抽吸与BMS植入后更好的ISR发生率相关。
