Key result
Distal protection during PCI for large-thrombus AMI is linked to ~170% higher odds of achieving MBG-3.
Why the study?
The presence of intracoronary large thrombus burden increases the risk of distal embolization and no-reflow during primary PCI, and the effect of distal protection on these outcomes was unclear.
Does distal protection during primary PCI improve myocardial reperfusion and reduce infarct size in patients with acute myocardial infarction, particularly those with large thrombus burden?
Comparison
Distal protection during primary PCI vs primary PCI alone
Design
Consecutive cohort study with blinded outcome assessment
Authors
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May support selective distal protection in large-thrombus AMI; leaves open outcome benefits pending randomized trials.
Cohort (n=169)
Blinded outcome assessment
No
Does distal protection during primary PCI improve myocardial reperfusion and reduce infarct size in patients with acute myocardial infarction, particularly those with large thrombus burden?
Odds Ratio: 2.7 (95% CI 1.03–7.08)
Absolute Event Rate: 61.9% vs 35.3%
p-value: p=0.043
Distal protection during primary PCI improves myocardial reperfusion and reduces infarct size specifically in patients with a large intracoronary thrombus burden.
Umeda et al. (2006) conducted a cohort in Acute myocardial infarction (n=169). Distal protection device (GuardWire Plus) vs. Primary percutaneous coronary intervention alone was evaluated on Postprocedural myocardial blush grade 3 (MBG-3) in patients with large thrombus burden (OR 2.70, 95% CI 1.03-7.08, p=0.043). In patients with acute myocardial infarction and large thrombus burden, the use of a distal protection device during primary percutaneous coronary intervention significantly improved myocardial reperfusion, increasing the odds of achieving myocardial blush grade 3 (OR 2.70).
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