Predictors and time-related impact of distal embolization during primary angioplasty
Key result
Distal embolization complicates ~16% of primary PCIs and reduces myocardial reperfusion effectiveness in early presenters.
- P<0.0001
- n=400
Why the study?
What are the predictors of distal embolization during primary PCI and how does it impact myocardial reperfusion and necrosis based on time-to-treatment?
Population
400 consecutive patients undergoing primary percutaneous coronary intervention (p-PCI)
Comparison
Distal embolization (DE) during p-PCI vs No distal embolization during p-PCI
Design
Cohort
Authors
Discussion
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Member takes
Implication
Distal embolization may impair early reperfusion; leaves open whether thrombus-directed strategies improve outcomes in primary PCI.
Study Design
Type
Cohort (n=400)
Structured PICO
What are the predictors of distal embolization during primary PCI and how does it impact myocardial reperfusion and necrosis based on time-to-treatment?
P
Population
400 consecutive patients undergoing primary percutaneous coronary intervention.
E
Exposure
Distal embolization (DE) during p-PCI
C
Comparator
No distal embolization during p-PCI
O
Outcome
Predictors of distal embolization and its impact on Thrombolysis in Myocardial Infarction (TIMI) flow, myocardial blush, and troponin I (TnI) according to symptom onset-to-balloon timesurrogate
Main Result
p-value: p=<0.0001
Distal embolization during primary PCI is predicted by high thrombus burden and worsens myocardial reperfusion and damage particularly when time-to-treatment is short (<6 hours).
Cite This Study
Napodano et al. (2008) conducted a cohort in Myocardial infarction undergoing primary PCI (n=400). Distal embolization during primary PCI vs. No distal embolization was evaluated on Impact of distal embolization on TIMI flow, myocardial blush, and troponin I according to time-to-treatment (p=<0.0001). Distal embolization during primary PCI occurred in 16% of patients and significantly reduced myocardial reperfusion effectiveness when time-to-treatment was ≤6 hours (P<0.0001).