Clinical impact of thrombus aspiration during primary percutaneous coronary intervention: Results from Korea Acute Myocardial Infarction Registry

Daisuke Hachinohe, Myung Ho Jeong, Shigeru Saito, Min Chol Kim, Kyung Hoon Cho, Khurshid Ahmed, Seung Hwan Hwang, Min Goo Lee, Doo Sun Sim, Keun Ho Park, Ju Han Kim, Young Joon Hong, Youngkeun Ahn, Jung Chaee Kang, Jong Hyun Kim, Shung Chull Chae, Young Jo Kim, Seung Ho Hur, In Whan Seong, Taek Jong HongDonghoon Choi, Myeong Chan Cho, Chong Jin Kim, Ki Bae Seung, Wook Sung Chung, Yang Soo Jang, Seung-Woon Rha, Jang Ho Bae, Seung Jung Park, Myung Ho Jeong, Young Jo Kim, Chong Jin Kim, Myeong Chan Cho, Young Keun Ahn, Jong Hyun Kim, Shung Chull Chae, Seung Ho Hur, In Whan Seong, Taek Jong Hong, Dong Hoon Choi, Jei Keon Chae, Jae Young Rhew, Doo Il Kim, In Ho Chae, Jung Han Yoon, Bon Kwon Koo, Byung Ok Kim, Myoung Yong Lee, Kee Sik Kim, Jin Yong Hwang, Seok Kyu Oh, Nae Hee Lee, Kyoung Tae Jeong, Seung Jea Tahk, Jang Ho Bae, Seung Woon Rha, Keum Soo Park, Kyoo Rok Han, Tae Hoon Ahn, Moo Hyun Kim, Ju Young Yang, Chong Yun Rhim, Hyeon Cheol Gwon, Seong Wook Park, Young Youp Koh, Seung Jae Joo, Soo Joong Kim, Dong Kyu Jin, Jin Man Cho, Jeong Gwan Cho, Wook Sung Chung, Yang Soo Jang, Ki Bae Seung, Seung Jung Park

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background: The role of thrombus aspiration (TA) as an adjunct to primary percutaneous coronary intervention (PPCI) remains a matter of controversy. Methods and results: A total of 2105 patients enrolled in the nationwide prospective Korea Acute Myocardial Infarction Registry, a cohort of 745 (35.4%) patients who underwent TA during PPCI was compared with 1360 (64.6%) patients who underwent conventional PCI without TA. Clinical outcomes at 12-months of overall enrolled patients and subgroups according to key variables were assessed using Cox regression models adjusted by propensity score. Although there was no significant difference among overall patients, in subgroup analyses, administration of glycoprotein (GP) IIb/IIIa inhibitor during PPCI [adjusted hazard ratio (HR) 0.329, 95% confidence interval (CI) 0.126-0.860, p=0.023] and left anterior descending (LAD) as a culprit lesion (adjusted HR 0.516, 95% CI 0.275-0.971, p=0.040) were the settings, in which TA was associated with a lower major adverse cardiac events (MACE) rate compared with non-TA. Conclusions: Although TA does not improve clinical outcomes in overall patients who underwent PPCI, TA for LAD occlusion improves 12-month MACE. Furthermore, use of GP IIb/IIIa inhibitor with TA has a synergistic effect on clinical outcomes.

Original languageEnglish
Pages (from-to)249-257
Number of pages9
JournalJournal of Cardiology
Volume59
Issue number3
DOIs
Publication statusPublished - 2012 May 1

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Percutaneous Coronary Intervention
Korea
Registries
Thrombosis
Myocardial Infarction
Platelet Glycoprotein GPIIb-IIIa Complex
Confidence Intervals
Propensity Score
Proportional Hazards Models

Keywords

  • Percutaneous coronary intervention
  • ST-elevation myocardial infarction
  • Thrombus aspiration

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Clinical impact of thrombus aspiration during primary percutaneous coronary intervention : Results from Korea Acute Myocardial Infarction Registry. / Hachinohe, Daisuke; Jeong, Myung Ho; Saito, Shigeru; Kim, Min Chol; Cho, Kyung Hoon; Ahmed, Khurshid; Hwang, Seung Hwan; Lee, Min Goo; Sim, Doo Sun; Park, Keun Ho; Kim, Ju Han; Hong, Young Joon; Ahn, Youngkeun; Kang, Jung Chaee; Kim, Jong Hyun; Chae, Shung Chull; Kim, Young Jo; Hur, Seung Ho; Seong, In Whan; Hong, Taek Jong; Choi, Donghoon; Cho, Myeong Chan; Kim, Chong Jin; Seung, Ki Bae; Chung, Wook Sung; Jang, Yang Soo; Rha, Seung-Woon; Bae, Jang Ho; Park, Seung Jung; Jeong, Myung Ho; Kim, Young Jo; Kim, Chong Jin; Cho, Myeong Chan; Ahn, Young Keun; Kim, Jong Hyun; Chae, Shung Chull; Hur, Seung Ho; Seong, In Whan; Hong, Taek Jong; Choi, Dong Hoon; Chae, Jei Keon; Rhew, Jae Young; Kim, Doo Il; Chae, In Ho; Yoon, Jung Han; Koo, Bon Kwon; Kim, Byung Ok; Lee, Myoung Yong; Kim, Kee Sik; Hwang, Jin Yong; Oh, Seok Kyu; Lee, Nae Hee; Jeong, Kyoung Tae; Tahk, Seung Jea; Bae, Jang Ho; Rha, Seung Woon; Park, Keum Soo; Han, Kyoo Rok; Ahn, Tae Hoon; Kim, Moo Hyun; Yang, Ju Young; Rhim, Chong Yun; Gwon, Hyeon Cheol; Park, Seong Wook; Koh, Young Youp; Joo, Seung Jae; Kim, Soo Joong; Jin, Dong Kyu; Cho, Jin Man; Cho, Jeong Gwan; Chung, Wook Sung; Jang, Yang Soo; Seung, Ki Bae; Park, Seung Jung.

In: Journal of Cardiology, Vol. 59, No. 3, 01.05.2012, p. 249-257.

Research output: Contribution to journalArticle

Hachinohe, D, Jeong, MH, Saito, S, Kim, MC, Cho, KH, Ahmed, K, Hwang, SH, Lee, MG, Sim, DS, Park, KH, Kim, JH, Hong, YJ, Ahn, Y, Kang, JC, Kim, JH, Chae, SC, Kim, YJ, Hur, SH, Seong, IW, Hong, TJ, Choi, D, Cho, MC, Kim, CJ, Seung, KB, Chung, WS, Jang, YS, Rha, S-W, Bae, JH, Park, SJ, Jeong, MH, Kim, YJ, Kim, CJ, Cho, MC, Ahn, YK, Kim, JH, Chae, SC, Hur, SH, Seong, IW, Hong, TJ, Choi, DH, Chae, JK, Rhew, JY, Kim, DI, Chae, IH, Yoon, JH, Koo, BK, Kim, BO, Lee, MY, Kim, KS, Hwang, JY, Oh, SK, Lee, NH, Jeong, KT, Tahk, SJ, Bae, JH, Rha, SW, Park, KS, Han, KR, Ahn, TH, Kim, MH, Yang, JY, Rhim, CY, Gwon, HC, Park, SW, Koh, YY, Joo, SJ, Kim, SJ, Jin, DK, Cho, JM, Cho, JG, Chung, WS, Jang, YS, Seung, KB & Park, SJ 2012, 'Clinical impact of thrombus aspiration during primary percutaneous coronary intervention: Results from Korea Acute Myocardial Infarction Registry', Journal of Cardiology, vol. 59, no. 3, pp. 249-257. https://doi.org/10.1016/j.jjcc.2011.12.005
Hachinohe, Daisuke ; Jeong, Myung Ho ; Saito, Shigeru ; Kim, Min Chol ; Cho, Kyung Hoon ; Ahmed, Khurshid ; Hwang, Seung Hwan ; Lee, Min Goo ; Sim, Doo Sun ; Park, Keun Ho ; Kim, Ju Han ; Hong, Young Joon ; Ahn, Youngkeun ; Kang, Jung Chaee ; Kim, Jong Hyun ; Chae, Shung Chull ; Kim, Young Jo ; Hur, Seung Ho ; Seong, In Whan ; Hong, Taek Jong ; Choi, Donghoon ; Cho, Myeong Chan ; Kim, Chong Jin ; Seung, Ki Bae ; Chung, Wook Sung ; Jang, Yang Soo ; Rha, Seung-Woon ; Bae, Jang Ho ; Park, Seung Jung ; Jeong, Myung Ho ; Kim, Young Jo ; Kim, Chong Jin ; Cho, Myeong Chan ; Ahn, Young Keun ; Kim, Jong Hyun ; Chae, Shung Chull ; Hur, Seung Ho ; Seong, In Whan ; Hong, Taek Jong ; Choi, Dong Hoon ; Chae, Jei Keon ; Rhew, Jae Young ; Kim, Doo Il ; Chae, In Ho ; Yoon, Jung Han ; Koo, Bon Kwon ; Kim, Byung Ok ; Lee, Myoung Yong ; Kim, Kee Sik ; Hwang, Jin Yong ; Oh, Seok Kyu ; Lee, Nae Hee ; Jeong, Kyoung Tae ; Tahk, Seung Jea ; Bae, Jang Ho ; Rha, Seung Woon ; Park, Keum Soo ; Han, Kyoo Rok ; Ahn, Tae Hoon ; Kim, Moo Hyun ; Yang, Ju Young ; Rhim, Chong Yun ; Gwon, Hyeon Cheol ; Park, Seong Wook ; Koh, Young Youp ; Joo, Seung Jae ; Kim, Soo Joong ; Jin, Dong Kyu ; Cho, Jin Man ; Cho, Jeong Gwan ; Chung, Wook Sung ; Jang, Yang Soo ; Seung, Ki Bae ; Park, Seung Jung. / Clinical impact of thrombus aspiration during primary percutaneous coronary intervention : Results from Korea Acute Myocardial Infarction Registry. In: Journal of Cardiology. 2012 ; Vol. 59, No. 3. pp. 249-257.
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abstract = "Background: The role of thrombus aspiration (TA) as an adjunct to primary percutaneous coronary intervention (PPCI) remains a matter of controversy. Methods and results: A total of 2105 patients enrolled in the nationwide prospective Korea Acute Myocardial Infarction Registry, a cohort of 745 (35.4{\%}) patients who underwent TA during PPCI was compared with 1360 (64.6{\%}) patients who underwent conventional PCI without TA. Clinical outcomes at 12-months of overall enrolled patients and subgroups according to key variables were assessed using Cox regression models adjusted by propensity score. Although there was no significant difference among overall patients, in subgroup analyses, administration of glycoprotein (GP) IIb/IIIa inhibitor during PPCI [adjusted hazard ratio (HR) 0.329, 95{\%} confidence interval (CI) 0.126-0.860, p=0.023] and left anterior descending (LAD) as a culprit lesion (adjusted HR 0.516, 95{\%} CI 0.275-0.971, p=0.040) were the settings, in which TA was associated with a lower major adverse cardiac events (MACE) rate compared with non-TA. Conclusions: Although TA does not improve clinical outcomes in overall patients who underwent PPCI, TA for LAD occlusion improves 12-month MACE. Furthermore, use of GP IIb/IIIa inhibitor with TA has a synergistic effect on clinical outcomes.",
keywords = "Percutaneous coronary intervention, ST-elevation myocardial infarction, Thrombus aspiration",
author = "Daisuke Hachinohe and Jeong, {Myung Ho} and Shigeru Saito and Kim, {Min Chol} and Cho, {Kyung Hoon} and Khurshid Ahmed and Hwang, {Seung Hwan} and Lee, {Min Goo} and Sim, {Doo Sun} and Park, {Keun Ho} and Kim, {Ju Han} and Hong, {Young Joon} and Youngkeun Ahn and Kang, {Jung Chaee} and Kim, {Jong Hyun} and Chae, {Shung Chull} and Kim, {Young Jo} and Hur, {Seung Ho} and Seong, {In Whan} and Hong, {Taek Jong} and Donghoon Choi and Cho, {Myeong Chan} and Kim, {Chong Jin} and Seung, {Ki Bae} and Chung, {Wook Sung} and Jang, {Yang Soo} and Seung-Woon Rha and Bae, {Jang Ho} and Park, {Seung Jung} and Jeong, {Myung Ho} and Kim, {Young Jo} and Kim, {Chong Jin} and Cho, {Myeong Chan} and Ahn, {Young Keun} and Kim, {Jong Hyun} and Chae, {Shung Chull} and Hur, {Seung Ho} and Seong, {In Whan} and Hong, {Taek Jong} and Choi, {Dong Hoon} and Chae, {Jei Keon} and Rhew, {Jae Young} and Kim, {Doo Il} and Chae, {In Ho} and Yoon, {Jung Han} and Koo, {Bon Kwon} and Kim, {Byung Ok} and Lee, {Myoung Yong} and Kim, {Kee Sik} and Hwang, {Jin Yong} and Oh, {Seok Kyu} and Lee, {Nae Hee} and Jeong, {Kyoung Tae} and Tahk, {Seung Jea} and Bae, {Jang Ho} and Rha, {Seung Woon} and Park, {Keum Soo} and Han, {Kyoo Rok} and Ahn, {Tae Hoon} and Kim, {Moo Hyun} and Yang, {Ju Young} and Rhim, {Chong Yun} and Gwon, {Hyeon Cheol} and Park, {Seong Wook} and Koh, {Young Youp} and Joo, {Seung Jae} and Kim, {Soo Joong} and Jin, {Dong Kyu} and Cho, {Jin Man} and Cho, {Jeong Gwan} and Chung, {Wook Sung} and Jang, {Yang Soo} and Seung, {Ki Bae} and Park, {Seung Jung}",
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TY - JOUR

T1 - Clinical impact of thrombus aspiration during primary percutaneous coronary intervention

T2 - Results from Korea Acute Myocardial Infarction Registry

AU - Hachinohe, Daisuke

AU - Jeong, Myung Ho

AU - Saito, Shigeru

AU - Kim, Min Chol

AU - Cho, Kyung Hoon

AU - Ahmed, Khurshid

AU - Hwang, Seung Hwan

AU - Lee, Min Goo

AU - Sim, Doo Sun

AU - Park, Keun Ho

AU - Kim, Ju Han

AU - Hong, Young Joon

AU - Ahn, Youngkeun

AU - Kang, Jung Chaee

AU - Kim, Jong Hyun

AU - Chae, Shung Chull

AU - Kim, Young Jo

AU - Hur, Seung Ho

AU - Seong, In Whan

AU - Hong, Taek Jong

AU - Choi, Donghoon

AU - Cho, Myeong Chan

AU - Kim, Chong Jin

AU - Seung, Ki Bae

AU - Chung, Wook Sung

AU - Jang, Yang Soo

AU - Rha, Seung-Woon

AU - Bae, Jang Ho

AU - Park, Seung Jung

AU - Jeong, Myung Ho

AU - Kim, Young Jo

AU - Kim, Chong Jin

AU - Cho, Myeong Chan

AU - Ahn, Young Keun

AU - Kim, Jong Hyun

AU - Chae, Shung Chull

AU - Hur, Seung Ho

AU - Seong, In Whan

AU - Hong, Taek Jong

AU - Choi, Dong Hoon

AU - Chae, Jei Keon

AU - Rhew, Jae Young

AU - Kim, Doo Il

AU - Chae, In Ho

AU - Yoon, Jung Han

AU - Koo, Bon Kwon

AU - Kim, Byung Ok

AU - Lee, Myoung Yong

AU - Kim, Kee Sik

AU - Hwang, Jin Yong

AU - Oh, Seok Kyu

AU - Lee, Nae Hee

AU - Jeong, Kyoung Tae

AU - Tahk, Seung Jea

AU - Bae, Jang Ho

AU - Rha, Seung Woon

AU - Park, Keum Soo

AU - Han, Kyoo Rok

AU - Ahn, Tae Hoon

AU - Kim, Moo Hyun

AU - Yang, Ju Young

AU - Rhim, Chong Yun

AU - Gwon, Hyeon Cheol

AU - Park, Seong Wook

AU - Koh, Young Youp

AU - Joo, Seung Jae

AU - Kim, Soo Joong

AU - Jin, Dong Kyu

AU - Cho, Jin Man

AU - Cho, Jeong Gwan

AU - Chung, Wook Sung

AU - Jang, Yang Soo

AU - Seung, Ki Bae

AU - Park, Seung Jung

PY - 2012/5/1

Y1 - 2012/5/1

N2 - Background: The role of thrombus aspiration (TA) as an adjunct to primary percutaneous coronary intervention (PPCI) remains a matter of controversy. Methods and results: A total of 2105 patients enrolled in the nationwide prospective Korea Acute Myocardial Infarction Registry, a cohort of 745 (35.4%) patients who underwent TA during PPCI was compared with 1360 (64.6%) patients who underwent conventional PCI without TA. Clinical outcomes at 12-months of overall enrolled patients and subgroups according to key variables were assessed using Cox regression models adjusted by propensity score. Although there was no significant difference among overall patients, in subgroup analyses, administration of glycoprotein (GP) IIb/IIIa inhibitor during PPCI [adjusted hazard ratio (HR) 0.329, 95% confidence interval (CI) 0.126-0.860, p=0.023] and left anterior descending (LAD) as a culprit lesion (adjusted HR 0.516, 95% CI 0.275-0.971, p=0.040) were the settings, in which TA was associated with a lower major adverse cardiac events (MACE) rate compared with non-TA. Conclusions: Although TA does not improve clinical outcomes in overall patients who underwent PPCI, TA for LAD occlusion improves 12-month MACE. Furthermore, use of GP IIb/IIIa inhibitor with TA has a synergistic effect on clinical outcomes.

AB - Background: The role of thrombus aspiration (TA) as an adjunct to primary percutaneous coronary intervention (PPCI) remains a matter of controversy. Methods and results: A total of 2105 patients enrolled in the nationwide prospective Korea Acute Myocardial Infarction Registry, a cohort of 745 (35.4%) patients who underwent TA during PPCI was compared with 1360 (64.6%) patients who underwent conventional PCI without TA. Clinical outcomes at 12-months of overall enrolled patients and subgroups according to key variables were assessed using Cox regression models adjusted by propensity score. Although there was no significant difference among overall patients, in subgroup analyses, administration of glycoprotein (GP) IIb/IIIa inhibitor during PPCI [adjusted hazard ratio (HR) 0.329, 95% confidence interval (CI) 0.126-0.860, p=0.023] and left anterior descending (LAD) as a culprit lesion (adjusted HR 0.516, 95% CI 0.275-0.971, p=0.040) were the settings, in which TA was associated with a lower major adverse cardiac events (MACE) rate compared with non-TA. Conclusions: Although TA does not improve clinical outcomes in overall patients who underwent PPCI, TA for LAD occlusion improves 12-month MACE. Furthermore, use of GP IIb/IIIa inhibitor with TA has a synergistic effect on clinical outcomes.

KW - Percutaneous coronary intervention

KW - ST-elevation myocardial infarction

KW - Thrombus aspiration

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