Abstract 4199: Distal Protection Device in Primary Percutaneous Coronary Intervention for Fresh Acute Myocardial Infarction: Data From Kamir (Korean Acute Myocardial Infarction Registry)
Introduction: Distal embolization occurred frequently in primary PCI for acute myocardial infarction patient and was associated with disturbance of myocardial perfusion and adverse clinical outcomes. We aimed to verify ability of distal protection device for improvement clinical outcomes in clinical settings of fresh myocardial infarction.
Methods: 1050 patients(male 72.5%, Age 58±12 yr) with acute ST elevation myocardial infarction who underwent PCI within 3 hours from onset of symptom were involved. Enrolled patients were divided into two groups according to application of distal protection device. We checked baseline clinical characteristics, laboratory findings, and angiographic data. Clinical outcomes including major advance cardiac events (MACE) during 1 year follow up according were analyzed between two groups.
Results: There was no statistically significant difference in clinical, angiographic, echocardiographic data between two groups. Survival analysis using multivariate Cox regression showed no significant difference in development of total MACE (HR 0.854, p=0.435, 95% CI:0.585–3.476) and death/MI (HR 0.922, p=0.910, 95% CI:0.266 – 4.410) during 1 year follow up between two groups. In subgroup analysis according to presence LV dysfunction and usage of glycogen IIb IIIa inhibitor, distal protection device was not independent predictor of MACE and death/MI after primary PCI.
Conclusion: In analysis of registry data from KAMIR, distal protection device could not improve major clinical outcomes of primary PCI within 3hrs from onset of symptom for acute ST elevation myocardial infarction.