Abstract 14077: Efficacy of Distal Protection Device on Correlates of Adverse Events in Patients with Acute Myocardial Infarction
Background: Though it is clearly shown that distal embolization during percutaneous coronary intervention (PCI) worsens a prognosis after acute myocardial infarction (AMI), efficacies of distal protection (DP) devices are still controversial. The aim of this study is to investigate whether a DP device can improve reperfusion and major adverse cardiovascular events (MACE) in-hospital.
Methods: We studied consecutive 112 AMI patients who underwent primary PCI and divided into 2 groups based on the use of DP device " FiltrapTM ". Final corrected TIMI frame count (CTFC) and MACE were compared. MACE was defined as cardiac death, ventricular fibrillation, ventricular tachycardia, congestive heart disease, and target vessel failure.
Results: At the baseline characteristics, DP group (n=56) had significantly greater plaque burden in minimal lumen cross-sectional area than in the non-DP group (n=56) (16.5±5.7mm2 vs. 13.0±4.2mm2, P < 0.01). Nevertheless, the incidence of post PCI TIMI grade 3 was equivalent in both groups and the excellent reperfusion flow (CTFC < 14) was more frequently observed in the DP group (23.2% vs. 8.9%, P=0.04). MACE rates in-hospital was significantly lower in the DP group (16.1% vs. 33.9%, P=0.03). By logistic regression analyses, PCI without DP was significant predictor for MACE (OR 2.7, P=0.03).
Conclusion: Distal protection using FiltrapTM can achieve excellent reperfusion flow despite in lesions with higher plaque burden and associate with improving short-term clinical outcomes in patients with AMI.
- © 2012 by American Heart Association, Inc.