Which Intraprocedural Thrombotic Events Impact Clinical Outcomes After Percutaneous Coronary Intervention in Acute Coronary Syndromes?: A Pooled Analysis of the HORIZONS-AMI and ACUITY Trials

JACC. Cardiovascular Interventions
Jeffrey D WesslerAjay J Kirtane

Abstract

This study sought to determine the extent to which individual components of intraprocedural thrombotic events (IPTEs) are associated with adverse events. IPTEs occurring during percutaneous coronary intervention (PCI) are associated with adverse in-hospital and late outcomes in patients with acute coronary syndromes. A total of 6,591 patients who underwent PCI for non-ST-segment elevation acute coronary syndromes/ST-segment elevation myocardial infarction in the ACUITY (Acute Catheterization and Urgent Intervention Triage StrategY) and HORIZONS-AMI (Harmonizing Outcomes with RevascularIZatiON and Stents in Acute Myocardial Infarction) trials underwent detailed frame-by-frame core laboratory angiographic analysis to assess for IPTEs. The associations of IPTE components with death, major bleeding, and major adverse cardiac events at 30 days were assessed using univariable analyses and multivariable models. The overall incidence of IPTEs was 7.7%, with a greater incidence in ST-segment elevation myocardial infarction patients (12.2%) compared with non-ST-segment elevation acute coronary syndromes patients (3.5%). Specific components of IPTEs included no-reflow/slow reflow in 58.0%, new/worsened thrombus in 35.3%, distal embolizati...Continue Reading

References

Feb 19, 2002·Journal of the American College of Cardiology·Gregg W StoneMartin B Leon
Dec 4, 2003·Journal of the American College of Cardiology·Rajendra H MehtaUNKNOWN Primary Angioplasty in Myocardial Infarction (PAMI) Investigators
Nov 25, 2006·The New England Journal of Medicine·Gregg W StoneUNKNOWN ACUITY Investigators
Feb 14, 2007·The New England Journal of Medicine·Gregg W StoneMartin B Leon
May 24, 2008·The New England Journal of Medicine·Gregg W StoneUNKNOWN HORIZONS-AMI Trial Investigators
May 28, 2010·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Paul FeferAmit Segev
Mar 20, 2013·Current Vascular Pharmacology·Olivier MullerEric Eeckhout

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Citations

Jun 10, 2017·Journal of the American College of Cardiology·Jacob LønborgUNKNOWN DANAMI-3 Investigators
May 11, 2018·International Journal of Nursing Knowledge·Francine Monteiro MoreiraEduarda Ribeiro Dos Santos
Jun 11, 2016·Blood·Neal S Kleiman
Oct 12, 2016·Circulation Journal : Official Journal of the Japanese Circulation Society·Shinya IchikawaKazuo Kimura

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