Author(s):
Pereira, H ; Caldeira, D ; Campante Teles, R ; Costa, M ; Canas da Silva, P ; da Gama Ribeiro, V ; Brandão, V ; Martins, D ; Matias, F ; Pereira-Machado, F ; Baptista, J ; Farto e Abreu, P ; Santos, R ; Drummond, A ; Cyrne de Carvalho, H ; Calisto, J ; Silva, JC ; Pipa, JL ; Marques, J ; Sousa, P ; Fernandes, R ; Cruz Ferreira, R ; Ramos, S ; Infante Oliveira, E ; de Sousa Almeida, M
Date: 2018
Persistent ID: http://hdl.handle.net/10400.17/3019
Origin: Repositório do Centro Hospitalar de Lisboa Central, EPE
Subject(s): HSM CAR; Coronary Thrombosis/diagnosis; Coronary Thrombosis/mortality; Portugal; Coronary Thrombosis/surgery; Hospital Mortality; Percutaneous Coronary Intervention/adverse effects; Percutaneous Coronary Intervention/mortality; Protective Factors; Registries; Retrospective Studies; Risk Assessment; Risk Factors; ST Elevation Myocardial Infarction/diagnosis; ST Elevation Myocardial Infarction/mortality; ST Elevation Myocardial Infarction/surgery; Thrombectomy/adverse effects; Thrombectomy/mortality; Time Factors; Treatment Outcome
Description
BACKGROUND: We aimed to evaluate the impact of thrombus aspiration (TA) during primary percutaneous coronary intervention (P-PCI) in 'real-world' settings. METHODS: We performed a retrospective study, using data from the National Registry of Interventional Cardiology (RNCI 2006-2012, Portugal) with ST-elevation myocardial infarction (STEMI) patients treated with P-PCI. The primary outcome, in-hospital mortality, was analysed through adjusted odds ratio (aOR) and 95% confidence intervals (95%CI). RESULTS: We assessed data for 9458 STEMI patients that undergone P-PCI (35% treated with TA). The risk of in-hospital mortality with TA (aOR 0.93, 95%CI:0.54-1.60) was not significantly decreased. After matching patients through the propensity score, TA reduced significantly the risk of in-hospital mortality (OR 0.58, 95%CI:0.35-0.98; 3500 patients). CONCLUSIONS: The whole cohort data does not support the routine use of TA in P-PCI, but the results of the propensity-score matched cohort suggests that the use of selective TA may improve the short-term risks of STEMI.
