Increased Rate of Stent Thrombosis and Target Lesion Revascularization After Filter Protection in Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction 15-Month Follow-Up of the DEDICATION (Drug Elution and Distal Protection in ST Elevation Myocardial Infarction) Trial

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

卷:55

Article

Kaltoft, Anne¹  Kelbaek, Henning²  Klovgaard, Lene²  Terkelsen, Christian Juhl¹  Clemmensen, Peter²  Helqvist, Steffen²  Lassen, Jens Flensted¹  Thuesen, Leif¹ 

[1] Aarhus Univ Hosp, Dept Cardiol, Skejby, Denmark

[2] Rigshosp, Copenhagen Univ Hosp, Dept Cardiol, DK-2100 Copenhagen, Denmark

关键词: primary PCI;    distal protection;    stent thrombosis;   

DOI  :  10.1016/j.jacc.2009.09.052

来源: Elsevier

【 摘 要 】

Objectives The purpose of this study was to evaluate the long-term effects of distal protection during percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI). Background The use of distal filter protection during primary PCI increases procedure complexity and may influence lesion treatment and stent implantation. Methods The STEMI patients were assigned to distal protection (DP) (n = 312) or conventional treatment (CT) (n = 314). Clinical follow-up was performed after 1, 6, and 15 months, and angiographic follow-up after 8 months. All target lesion revascularizations (TLRs) were clinically driven. We report the pre-specified end points of stent thrombosis according to the criteria of the Academic Research Consortium, TLR, and reinfarction after 15 months. Results The total number of stent thrombosis was 11 in the DP group and 4 in the CT group (p = 0.06). The rate of definite stent thrombosis was significantly increased in the DP group as compared with the CT group, with 9 cases versus 1 (p = 0.01). Clinically driven TLRs (31 patients vs. 18 patients, p = 0.05) and clinically driven target vessel revascularizations (37 patients vs. 22 patients, p = 0.04) were more frequent in the DP group. Conclusions In primary PCI for STEMI, the routine use of DP increased the incidence of stent thrombosis and clinically driven target lesion/vessel revascularization during 15 months of follow-up. (Drug Elution and Distal Protection in ST Elevation Myocardial Infarction Trial [ DEDICATION]; NCT00192868) (J Am Coll Cardiol 2010; 55: 867-71) (C) 2010 by the American College of Cardiology Foundation

【 授权许可】

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