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ST분절 상승 급성심근경색의 일차적 관상동맥중재시술에서 혈전흡인술의 효과와 미세혈관저항과의 연관성

Thrombus Aspiration during Primary Percutaneous Coronary Intervention for Preserving the Index of Microcirculatory Resistance: A Randomised Study

초록/요약

Aims: We aimed to investigate whether thrombus aspiration could preserve the index of microcirculatory resistance (IMR) after primary percutaneous coronary intervention (PCI) in patients with ST-elevation myocardial infarction (STEMI). Methods and results: Sixty-three patients with STEMI were randomised into 2 groups: primary PCI after thrombus aspiration (aspiration group, n=33) and primary PCI without thrombus aspiration (non-aspiration group, n=30). IMR was measured using the pressure-temperature sensor-tipped coronary wire. Echocardiography were performed at baseline and at six-month follow-up. No significant differences in baseline ejection fraction (EF, 47.3±8.5% vs. 49.5±7.8%, p=0.281) and baseline wall motion score index (WMSI, 1.45±0.31 vs. 1.37±0.27, p=0.299) were observed between the two groups. However, significant differences in IMR (23.5±10.2 U vs. 34.2±21.7 U, p=0.018), ∆EF (follow-up EF - baseline EF; 3.33±4.6% vs. 0.73±1.9%, p=0.005), and ∆WMSI (follow-up WMSI – baseline WMSI; -0.121±0.16 vs. -0.004±0.07, p=0.001) were observed between the two groups. Conclusions: Thrombus aspiration as an adjunctive method to primary PCI for STEMI may preserve microvascular integrity and have beneficial effects on myocardial microcirculation.

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목차

ABSTRACT i
TABLE OF CONTENTS iii
LIST OF FIGURES iv
LIST OF TABLES v
Ⅰ. INTRODUCTION 1
Ⅱ. MATERIALS AND METHODS 2
A. PATIENTS 2
B. STUDY PROTOCOL AND PROCEDURE 2
C. PHYSIOLOGICAL ASSESSMENT 3
D. ANGIOGRAPHY 4
F. ECHOCARDIOGRAPHIC ANALYSIS 4
G. BLOOD SAMPLES 4
H. CORONARY RISK FACTORS 5
I. STATISTICAL ANALYSIS 5
Ⅲ. RESULTS 6
A. BASELINE CHARACERRISTICS 6
B. ANGIOGRAPHIC AND PERIPROCEDURAL FINDINGS 8
C. PHYSIOLOGIC AND ECHOCARDIOGRAPHIC FINDINGS 11
Ⅳ. DISCUSSION 14
V. LIMITATIONS 17
ⅤI. CONCLUSION 18
REFERENCES 19
국문요약

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