Impact of manual thrombectomy on microvascular obstruction in STEMI patients.

Details

Serval ID
serval:BIB_19CAE02E682B
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Impact of manual thrombectomy on microvascular obstruction in STEMI patients.
Journal
Catheterization and cardiovascular interventions
Author(s)
Meier D., Fournier S., Masci P.G., Eeckhout E., Antiochos P., Tzimas G., Stoyanov N., Muenkaew M., Monney P., Schwitter J., Muller O., Harbaoui B.
ISSN
1522-726X (Electronic)
ISSN-L
1522-1946
Publication state
In Press
Peer-reviewed
Oui
Language
english
Notes
Publication types: Journal Article
Publication Status: aheadofprint
Abstract
To assess the effect of manual thrombectomy (MT) on microvascular obstruction (MVO) using cardiac magnetic resonance (CMR) in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI).
Three hundred and eighty-three patients admitted for STEMI and undergoing CMR fulfilled the inclusion criteria and were categorized into two groups (did or did not undergo MT). The two primary endpoints were the occurrence and extent of MVO, analyzed as a categorical variable and as a semicontinuous variable. Among the 383 patients, 49.1% exhibited MVO. Both the incidence of MVO and the median number of segments presenting with MVO were significantly higher in the MT group than in the no-MT group, (59.5 vs. 38.9%, p < .001) and (1.5 [0;4] vs. 0 [0;2], p < .001). Analysis stratified on coronary thrombus grade showed similar results, only in patients with a high thrombus burden (60.7 vs. 43.5%, p = .004, and 2 [0;4] vs. 0 [0;3], p = .001). When adjusting for baseline differences, MT remained a determinant of MVO occurrence and extent (odds ratio, OR 1.802 [95% confidence interval, CI 1.080-3.009], p = .024) and β = .137, p = .024) in patients with a high thrombus grade.
In STEMI patients, MT was associated with the occurrence and extent of MVO, on CMR, especially in patients with a high thrombus burden.
Keywords
STEMI, cardiac magnetic resonance, mechanical thrombectomy, microvascular obstruction
Pubmed
Create date
25/04/2020 21:22
Last modification date
28/07/2020 6:26
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