TY - JOUR
T1 - Contemporary outcomes of rescue percutaneous coronary intervention for acute myocardial infarction
T2 - Comparison with primary angioplasty and the role of distal protection devices (EMERALD trial)
AU - Dangas, George
AU - Stone, Gregg W.
AU - Weinberg, Mitchell D.
AU - Webb, John
AU - Cox, David A.
AU - Brodie, Bruce R.
AU - Krucoff, Mitchell W.
AU - Gibbons, Raymond J.
AU - Lansky, Alexandra J.
AU - Mehran, Roxana
N1 - Funding Information:
The EMERALD study was funded by Medtronic Corp, Santa Rosa, California, US.
PY - 2008/6
Y1 - 2008/6
N2 - Background: The value of distal protection devices during rescue PCI has not been studied. Methods: The population enrolled in a prospective, randomized multicenter trial of distal microcirculatory protection in ST-elevation MI, was stratified for those undergoing rescue (n = 93) or primary (n = 408) PCI; we performed the prespecified comparisons of distal protection in rescue and primary PCI. Results: Compared to primary PCI, rescue patients had higher baseline rates of TIMI-3 flow, but lower rates of post PCI TIMI-3 flow. However, no differences in the primary endpoints of complete ST-segment resolution (STR) at 30 minutes or infarct size, or 6 month mortality were present. In rescue PCI patients, randomization to distal protection did not significantly affect infarct size, STR, mortality or other clinical events. Conclusion: Despite reduced rates of post-procedural TIMI-3 flow, patients undergoing rescue PCI compared to primary PCI have similar myocardial perfusion, infarct size and clinical outcomes. Distal protection did not offer any detectable benefit in this patient population.
AB - Background: The value of distal protection devices during rescue PCI has not been studied. Methods: The population enrolled in a prospective, randomized multicenter trial of distal microcirculatory protection in ST-elevation MI, was stratified for those undergoing rescue (n = 93) or primary (n = 408) PCI; we performed the prespecified comparisons of distal protection in rescue and primary PCI. Results: Compared to primary PCI, rescue patients had higher baseline rates of TIMI-3 flow, but lower rates of post PCI TIMI-3 flow. However, no differences in the primary endpoints of complete ST-segment resolution (STR) at 30 minutes or infarct size, or 6 month mortality were present. In rescue PCI patients, randomization to distal protection did not significantly affect infarct size, STR, mortality or other clinical events. Conclusion: Despite reduced rates of post-procedural TIMI-3 flow, patients undergoing rescue PCI compared to primary PCI have similar myocardial perfusion, infarct size and clinical outcomes. Distal protection did not offer any detectable benefit in this patient population.
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U2 - 10.1016/j.ahj.2007.12.003
DO - 10.1016/j.ahj.2007.12.003
M3 - Article
C2 - 18513524
AN - SCOPUS:44149094303
SN - 0002-8703
VL - 155
SP - 1090
EP - 1096
JO - American heart journal
JF - American heart journal
IS - 6
ER -