TY - JOUR
T1 - Effect of Intracoronary Thrombectomy on 30-Day Mortality in Patients With Acute Myocardial Infarction
AU - Nakatani, Daisaku
AU - Sato, Hiroshi
AU - Sakata, Yasuhiko
AU - Mizuno, Hiroya
AU - Shimizu, Masahiko
AU - Suna, Shinichiro
AU - Nanto, Shinsuke
AU - Hirayama, Atsushi
AU - Ito, Hiroshi
AU - Fujii, Kenshi
AU - Hori, Masatsugu
N1 - Funding Information:
This work was supported by a Grant-in-Aid for University and Society Collaboration by Grant 17590730 from the Japanese Ministry of Education, Culture, Sports, Science, and Technology, Tokyo, Japan, and by a research grant from the Japan Arteriosclerosis Prevention Fund, Tokyo, Japan.
PY - 2007/10/15
Y1 - 2007/10/15
N2 - Insertion of intracoronary thrombectomy (ICT) devices, as a precedent to percutaneous coronary intervention (PCI), theoretically could have a beneficial effect on the outcome in patients with acute myocardial infarction. To examine whether ICT was associated with a lower 30-day mortality rate in patients with acute myocardial infarction, we studied 3,913 patients who underwent PCI within 24 hours after onset. A total of 990 patients (25.3%) were treated with ICT before PCI. The 30-day mortality rate was lower in the patients receiving ICT than in those without (3.7% vs 6.2%, p = 0.004), but this beneficial effect disappeared after adjustment for baseline characteristics (hazard ratio [HR] 0.658, p = 0.166). We also divided the patients into tertiles according to the Thrombolysis In Myocardial Infarction (TIMI) risk score. After adjustment for baseline characteristics, ICT was associated with a lower 30-day mortality rate in patients from the highest TIMI risk score tertile (HR 0.407, p = 0.029), but not in patients from the lower 2 tertiles. ICT was also an independent predictor of a lower 30-day mortality risk in patients aged ≥70 years (HR 0.239, p = 0.007), patients with diabetes mellitus (HR 0.275, p = 0.039), and those with stent implantation (HR 0.437, p = 0.034). In conclusion, in selected patients with high TIMI risk scores, an age ≥70 years, diabetes mellitus, or stenting, ICT is associated with a lower 30-day mortality rate.
AB - Insertion of intracoronary thrombectomy (ICT) devices, as a precedent to percutaneous coronary intervention (PCI), theoretically could have a beneficial effect on the outcome in patients with acute myocardial infarction. To examine whether ICT was associated with a lower 30-day mortality rate in patients with acute myocardial infarction, we studied 3,913 patients who underwent PCI within 24 hours after onset. A total of 990 patients (25.3%) were treated with ICT before PCI. The 30-day mortality rate was lower in the patients receiving ICT than in those without (3.7% vs 6.2%, p = 0.004), but this beneficial effect disappeared after adjustment for baseline characteristics (hazard ratio [HR] 0.658, p = 0.166). We also divided the patients into tertiles according to the Thrombolysis In Myocardial Infarction (TIMI) risk score. After adjustment for baseline characteristics, ICT was associated with a lower 30-day mortality rate in patients from the highest TIMI risk score tertile (HR 0.407, p = 0.029), but not in patients from the lower 2 tertiles. ICT was also an independent predictor of a lower 30-day mortality risk in patients aged ≥70 years (HR 0.239, p = 0.007), patients with diabetes mellitus (HR 0.275, p = 0.039), and those with stent implantation (HR 0.437, p = 0.034). In conclusion, in selected patients with high TIMI risk scores, an age ≥70 years, diabetes mellitus, or stenting, ICT is associated with a lower 30-day mortality rate.
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U2 - 10.1016/j.amjcard.2007.05.040
DO - 10.1016/j.amjcard.2007.05.040
M3 - Article
C2 - 17920359
AN - SCOPUS:34848906846
SN - 0002-9149
VL - 100
SP - 1212
EP - 1217
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 8
ER -
