Effect of coronary thrombus aspiration during primary percutaneous coronary intervention on one-year survival (from the FAST-MI 2010 registry).
Fiche publication
Date publication
décembre 2014
Journal
The American journal of cardiology
Auteurs
Membres identifiés du Cancéropôle Est :
Pr COTTIN Yves
Tous les auteurs :
Puymirat E, Aissaoui N, Cottin Y, Vanzetto G, Carrié D, Isaaz K, Valy Y, Tchetche D, Schiele F, Steg PG, Simon T, Danchin N
Lien Pubmed
Résumé
Results from randomized trials evaluating thrombus aspiration (TA) in patients with ST-elevation myocardial infarction (STEMI) are conflicting. We assessed 1-year survival in STEMI patients participating in the French Registry of Acute ST-Elevation and non-ST-Elevation Myocardial Infarction (FAST-MI) 2010 according to the use of TA during primary percutaneous coronary intervention (PCI). FAST-MI 2010 is a nationwide French registry that included 4,169 patients with acute myocardial infarction at the end of 2010 in 213 centers. Of those, 2,087 patients had STEMI, of whom 1,538 had primary PCI, with TA used in 671 (44%). Patients with TA were younger (61 ± 13.5 vs 63 ± 14 years), with a similar risk score of the Global Registry of Acute Coronary Events (140 ± 31 vs 143 ± 34) and a shorter median time from symptom onset (245 vs 285 minutes); location of acute myocardial infarction, history of myocardial infarction, PCI, or coronary artery bypass surgery did not differ significantly. Thirty-day mortality was 2.1% versus 2.1% (adjusted p = 0.18), and the rate of 1-year survival was 95.5% versus 94.8%. Using fully adjusted Cox multivariate analysis, hazard ratio for 1-year death was 1.13 (95% confidence interval 0.66 to 1.94). After propensity score matching (480 patients per group), 1-year survival was also similar with both strategies. In a real-world setting of patients admitted with STEMI, the use of TA during primary PCI was not associated with improved 1-year survival.
Mots clés
Aged, Coronary Angiography, Coronary Thrombosis, mortality, Female, France, epidemiology, Humans, Male, Middle Aged, Multivariate Analysis, Myocardial Infarction, mortality, Percutaneous Coronary Intervention, methods, Propensity Score, Proportional Hazards Models, Registries, Suction, methods, Survival Rate, Thrombectomy, methods, Time-to-Treatment, Treatment Outcome
Référence
Am. J. Cardiol.. 2014 Dec;114(11):1651-7