Intraprocedural thrombotic events during percutaneous coronary intervention in patients with non-ST-segment elevation acute coronary syndromes are associated with adverse outcomes: analysis from the ACUITY (Acute Catheterization and Urgent Intervention Triage Strategy) trial

Journal of the American College of Cardiology
Margaret McEntegartGregg W Stone

Abstract

The purpose of this study was to assess the prognostic impact of intraprocedural thrombotic events (IPTE) during percutaneous coronary intervention (PCI). Ischemic complications of PCI are infrequent but prognostically important. How often these events are a consequence of intraprocedural complications is unknown, with only limited data assessing the occurrence and importance of IPTE. A total of 3,428 patients who underwent PCI for non-ST-segment elevation acute coronary syndrome in the ACUITY (Acute Catheterization and Urgent Intervention Triage Strategy) trial underwent detailed frame-by-frame core laboratory angiographic analysis. An IPTE, defined as the development of new or increasing thrombus, abrupt vessel closure, no reflow, slow reflow, or distal embolization at any time during the procedure, occurred in 121 patients (3.5%). Patients with IPTE had higher in-hospital, 30-day, and 1-year major adverse cardiac event rates than patients without IPTE (25.6% vs. 6.3% in-hospital, 30.6% vs. 9.3% at 30 days, and 37.0% vs. 20.5% at 1 year; p < 0.0001 for each). An IPTE was strongly associated with Q-wave myocardial infarction and out-of-laboratory definite/probable stent thrombosis (in-hospital 3.3% vs. 0.5%, p = 0.006; 30 days...Continue Reading

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Citations

Jun 14, 2013·Journal of Neurointerventional Surgery·Ronil V Chandra
Jan 23, 2014·Cardiovascular Intervention and Therapeutics·Takahide KodamaEloisa Arbustini
Feb 25, 2014·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Sorin J BrenerGregg W Stone
Nov 9, 2014·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Eftal Murat BakirciErgun Topal
Nov 20, 2015·European Heart Journal. Acute Cardiovascular Care·Roza Meyer-SaraeiHolger Thiele
May 10, 2018·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Margaret McEntegartColin Berry
Apr 9, 2019·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Colin BerryPeter McCartney
Jul 12, 2019·Circulation Journal : Official Journal of the Japanese Circulation Society·Eun Kyoung KimSeung Woo Park
Oct 5, 2014·The International Journal of Cardiovascular Imaging·Giancarla ScaloneManel Sabaté
Mar 3, 2015·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Stephanie PlentGregg W Stone
Jun 23, 2015·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Michael J Lipinski, Lowell F Satler
May 5, 2018·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Hector TamezUNKNOWN CHAMPION PHOENIX ECONOMICS Investigators
Sep 13, 2014·Journal of the American College of Cardiology·Holger ThieleIngo Eitel

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