Effect of Intracoronary Thrombectomy on 30-Day Mortality in Patients With Acute Myocardial Infarction

Daisaku Nakatani, Hiroshi Sato, Yasuhiko Sakata, Hiroya Mizuno, Masahiko Shimizu, Shinichiro Suna, Shinsuke Nanto, Atsushi Hirayama, Hiroshi Ito, Kenshi Fujii, Masatsugu Hori

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Abstract

Insertion of intracoronary thrombectomy (ICT) devices, as a precedent to percutaneous coronary intervention (PCI), theoretically could have a beneficial effect on the outcome in patients with acute myocardial infarction. To examine whether ICT was associated with a lower 30-day mortality rate in patients with acute myocardial infarction, we studied 3,913 patients who underwent PCI within 24 hours after onset. A total of 990 patients (25.3%) were treated with ICT before PCI. The 30-day mortality rate was lower in the patients receiving ICT than in those without (3.7% vs 6.2%, p = 0.004), but this beneficial effect disappeared after adjustment for baseline characteristics (hazard ratio [HR] 0.658, p = 0.166). We also divided the patients into tertiles according to the Thrombolysis In Myocardial Infarction (TIMI) risk score. After adjustment for baseline characteristics, ICT was associated with a lower 30-day mortality rate in patients from the highest TIMI risk score tertile (HR 0.407, p = 0.029), but not in patients from the lower 2 tertiles. ICT was also an independent predictor of a lower 30-day mortality risk in patients aged ≥70 years (HR 0.239, p = 0.007), patients with diabetes mellitus (HR 0.275, p = 0.039), and those with stent implantation (HR 0.437, p = 0.034). In conclusion, in selected patients with high TIMI risk scores, an age ≥70 years, diabetes mellitus, or stenting, ICT is associated with a lower 30-day mortality rate.

Original languageEnglish
Pages (from-to)1212-1217
Number of pages6
JournalAmerican Journal of Cardiology
Volume100
Issue number8
DOIs
Publication statusPublished - 2007 Oct 15

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Nakatani, D., Sato, H., Sakata, Y., Mizuno, H., Shimizu, M., Suna, S., Nanto, S., Hirayama, A., Ito, H., Fujii, K., & Hori, M. (2007). Effect of Intracoronary Thrombectomy on 30-Day Mortality in Patients With Acute Myocardial Infarction. American Journal of Cardiology, 100(8), 1212-1217. https://doi.org/10.1016/j.amjcard.2007.05.040