Impact of distal embolization on myocardial perfusion and survival among patients undergoing primary angioplasty with glycoprotein IIb-IIIa inhibitors: insights from the EGYPT cooperation.

Journal of Thrombosis and Thrombolysis
Giuseppe De LucaArnoud W J Van't Hof

Abstract

Even though primary angioplasty is able to obtain TIMI 3 flow in the vast majority of STEMI patients, epicardial recanalization does not guarantee optimal myocardial perfusion, that remain suboptimal in a relatively large proportion of patients. Large interest has been focused in recent years on the role of distal embolization as major determinant of impaired reperfusion. The aim of the current study was to investigate in a large cohort of STEMI undergoing primary angioplasty with Gp IIb-IIIa inhibitors the impact of distal embolization on myocardial perfusion and survival. Our population is represented by patients undergoing primary angioplasty for STEMI included in the EGYPT database. Distal embolization was defined as an abrupt ''cutoff'' in the main vessel or one of the coronary branches of the infarct-related artery, distal to the angioplasty site. Myocardial perfusion was evaluated by angiography or ST-segment resolution, whereas infarct size was estimated by using peak CK and CK-MB. Follow-up data were collected between 30 days and 1 year after primary angioplasty. Data on distal embolization were available in a total of 1182 patients (71% of total population). Distal embolization was observed in 132 patients (11.1%). Pa...Continue Reading

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Citations

Nov 4, 2010·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Dariusz DudekKrzysztof Zmudka
Aug 10, 2013·Journal of Thrombosis and Thrombolysis·Giuseppe De LucaDavid Antoniucci
Jan 15, 2014·Nutrition, Metabolism, and Cardiovascular Diseases : NMCD·M VerdoiaUNKNOWN Novara Atherosclerosis Study Group (NAS)
Jul 24, 2014·Atherosclerosis·Monica VerdoiaUNKNOWN Novara Atherosclerosis Study Group (NAS)
Nov 29, 2013·Platelets·Monica VerdoiaUNKNOWN Novara Atherosreclerosis Study Group (NAS)
Feb 1, 2014·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Monica VerdoiaGiuseppe De Luca
Jul 30, 2014·International Heart Journal·Takeshi YamadaAkihiko Takahashi

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