Protection of Distal Embolization in High-Risk Patients With Acute ST-Segment Elevation Myocardial Infarction (PREMIAR)

Cura, Fernando; Escudero, Alejandro García; Berrocal, Daniel; Mendiz, Oscar; Trivi, Marcelo; Fernandez, J Gil; Palacios, Alejandro; Albertal, Mariano; Piraino, Rubén A; Riccitelli, Miguel A.; Gruberg, Luis; Ballarino, M; Milei, José; Baeza, Ricardo; Thierer, Jorge; Grinfeld, Liliana; Krucoff, Mitchell W.; O’Neill, William W.; Belardi, Jorge

doi:10.1016/j.amjcard.2006.08.038

Cited by 74 publications

(34 citation statements)

References 21 publications

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“…This improvement of STR over time after reperfusion, from 54% early STR to 71% late STR, is caused by a gradual, spontaneous recovery of the ST-segment. This finding is consistent with earlier studies [17][18][19][20] and has important consequences, in particular in considering additional therapies in persistent ST-segment elevation after PCI. Currently, additional therapies, such as vasodilators, glycoprotein IIb/IIIa receptor antagonists or an intra-aortic balloon pump, are mainly ap- plied in case of no reflow.…”

Section: Statistical Analysessupporting

confidence: 92%

Early versus late ST-segment resolution and clinical outcomes after percutaneous coronary intervention for acute myocardial infarction

Zwaan¹,

Stoel²,

Roos-Hesselink³

et al. 2010

NHJL

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Section: Statistical Analysessupporting

confidence: 92%

Early versus late ST-segment resolution and clinical outcomes after percutaneous coronary intervention for acute myocardial infarction

Zwaan¹,

Stoel²,

Roos-Hesselink³

et al. 2010

NHJL

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“…In this regard, the use of a mechanical device for thrombus removal or trapping to improve clinical outcomes after p-PCI is attractive, and the efficacy of these devices has been tested in many clinical trials. Although some data, especially those regarding the use of distal protection devices, have failed to show clinical benefits due in part to patient and device selection [48][49][50][51][52][53] , many recent large-scale randomized trials have demonstrated significant improvements in myocardial perfusion 45,[54][55][56][57][58][59][60][61][62][63][64][65][66][67] and the left ventricular function 64,65) in addition to reduced mortality 68) ( 69) . In addition, Burzotta et 70) .…”

Section: Thrombus Aspiration/distal Protection Therapy and Its Efficacymentioning

confidence: 99%

Thrombus Aspiration Therapy and Coronary Thrombus Components in Patients with Acute ST-Elevation Myocardial Infarction

Yunoki

Naruko

Sugioka

et al. 2013

JAT

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Inflammation and oxidative stress play key roles in atherosclerotic plaque instability, and plaque rupture/erosion and subsequent thrombus formation constitute the principal mechanisms of total vessel occlusion and acute ST-elevation myocardial infarction (STEMI). Plaque disruption triggers the formation of initial platelet aggregates that grow in association with an increase in fibrin formation, leading to persistent coronary flow obstruction and blood coagulation. The fibrin network may trap large numbers of erythrocytes and inflammatory cells to form an erythrocyte-rich thrombus. In fact, previous clinical studies have shown that not only platelet-rich white thrombi, but also erythrocyte-rich red thrombi can be visualized using angioscopy in patients with acute coronary syndrome. Recently, the development of thrombus aspiration and distal protection devices has significantly improved the clinical outcomes of percutaneous intervention in STEMI patients and has enabled the evaluation of antemortem coronary artery thrombi. This is important because previous autopsy studies were unable to differentiate coronary thrombi responsible for myocardial ischemia from postmortem clots. Using frozen samples of aspirated thrombi and specific monoclonal antibodies, we investigated the cellular components of thrombi (platelets, erythrocytes, fibrin and inflammatory cells, such as myeloperoxidase-positive cells) and pathologically evaluated the relationships between erythrocyterich thrombi and inflammation, oxidative stress and clinical outcomes in STEMI patients. Therefore, this review article focuses on the efficacy of thrombus aspiration therapy and the components of aspirated intracoronary thrombi in STEMI patients and presents the results of recent studies regarding the relationship between the composition of aspirated intracoronary thrombi and clinical outcomes.

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“…Visual myocardial perfusion grading is widely used to evaluate new interventional devices [18][19][20] and other therapeutic methods [21] in the field of coronary interventions. These studies still rely on the classic, semiquantitative method of visual assessment.…”

Section: Discussionmentioning

confidence: 99%

Vessel masking improves densitometric myocardial perfusion assessment

Ungi

Zimmermann

Balázs

et al. 2008

Int J Cardiovasc Imaging

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Protection of Distal Embolization in High-Risk Patients With Acute ST-Segment Elevation Myocardial Infarction (PREMIAR)

Cited by 74 publications

References 21 publications

Early versus late ST-segment resolution and clinical outcomes after percutaneous coronary intervention for acute myocardial infarction

Early versus late ST-segment resolution and clinical outcomes after percutaneous coronary intervention for acute myocardial infarction

Thrombus Aspiration Therapy and Coronary Thrombus Components in Patients with Acute ST-Elevation Myocardial Infarction

Vessel masking improves densitometric myocardial perfusion assessment

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