摘要
BackgroundDuringprimarypercutaneouscoronaryintervention(PCI),manualthrombectomymayreducedistalembolizationandthusimprovemicrovascularperfusion.Smalltrialshavesuggestedthatthrombectomyimprovessurrogateandclinicaloutcomes,butalargertrialhasreportedconflictingresults.MethodsWerandomlyassigned10,732patientswithST-segmentelevationmyocardialinfarction(STEMI)undergoingprimaryPCItoastrategyofroutineupfrontmanualthrombectomyversusPCIalone.Theprimaryoutcomewasacompositeofdeathfromcardiovascularcauses,recurrentmyocardialinfarction,cardiogenicshock,orNewYorkHeartAssociation(NYHA)classIVheartfailurewithin180days.Thekeysafetyoutcomewasstrokewithin30days.ResultsTheprimaryoutcomeoccurredin347of5033patients(6.9%)inthethrombectomygroupversus351of5030patients(7.0%)inthePCI-alonegroup(hazardratiointhethrombectomygroup,0.99;95%confidenceinterval[CI],0.85to1.15;P=0.86).Theratesofcardiovasculardeath(3.1%withthrombectomyvs.3.5%withPCIalone;hazardratio,0.90;95%CI,0.73to1.12;P=0.34)andtheprimaryoutcomeplusstentthrombosisortarget-vesselrevascularization(9.9%vs.9.8%;hazardratio,1.00;95%CI,0.89to1.14;P=0.95)werealsosimilar.Strokewithin30daysoccurredin33patients(0.7%)inthethrombectomygroupversus16patients(0.3%)inthePCI-alonegroup(hazardratio,2.06;95%CI,1.13to3.75;P=0.02).ConclusionsInpatientswithSTEMIwhowereundergoingprimaryPCI,routinemanualthrombectomy,ascomparedwithPCIalone,didnotreducetheriskofcardiovasculardeath,recurrentmyocardialinfarction,cardiogenicshock,orNYHAclassIVheartfailurewithin180daysbutwasassociatedwithanincreasedrateofstrokewithin30days.
出版日期
2015年01月11日（中国期刊网平台首次上网日期，不代表论文的发表时间）
