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Contemporary use of adjunctive thrombectomy during primary percutaneous coronary intervention for ST-elevation myocardial infarction in the United States.

Publication ,  Journal Article
Owan, TE; Roe, MT; Messenger, JC; Dai, D; Michaels, AD
Published in: Catheter Cardiovasc Interv
December 1, 2012

OBJECTIVES: We sought to examine the contemporary use of thrombectomy during primary percutaneous coronary intervention (PCI) in the United States. BACKGROUND: Adjunctive thrombectomy during primary PCI for patients with ST-segment elevation myocardial infarction (STEMI) has demonstrated mixed results. While earlier studies showed either unfavorable or neutral effects with rheolytic thrombectomy, recent clinical trials have shown benefits with manual or rheolytic thrombectomy when compared to PCI alone. METHODS: We analyzed data from 122,449 patients undergoing primary PCI for STEMI from 1,181 centers reported to the CathPCI Registry® between July 2009 and December 2010. We used logistic regression analysis to examine factors associated with the use of manual and rheolytic thrombectomy. RESULTS: Thrombectomy was performed in 23,195 patients (18.9%): 22,404 (18.3%) had manual thrombectomy and 791 (0.6%) had rheolytic thrombectomy. The use of manual thrombectomy increased over time (P < 0.05). The use of rheolytic thrombectomy did not change. There was significant variation in the use of thrombectomy across hospitals. The strongest predictors of manual versus no thrombectomy included TIMI 0/1 flow (odds ratio 1.69), younger age (OR 0.90 per 10 year increase), saphenous vein graft (OR 2.22), glycoprotein IIb/IIIa inhibitor (OR 1.34), single-vessel disease (OR 1.13), and year of admission (OR 1.20 per year; all P < 0.001). The strongest predictor of manual versus rheolytic thrombectomy was year of admission (OR 1.23, P < 0.001). CONCLUSIONS: Our data show that thrombectomy is performed infrequently in the US during primary PCI for STEMI. There is significant variation in the use of thrombectomy across US hospitals.

Duke Scholars

Published In

Catheter Cardiovasc Interv

DOI

EISSN

1522-726X

Publication Date

December 1, 2012

Volume

80

Issue

7

Start / End Page

1173 / 1180

Location

United States

Related Subject Headings

  • United States
  • Time Factors
  • Thrombectomy
  • Registries
  • Practice Patterns, Physicians'
  • Percutaneous Coronary Intervention
  • Patient Selection
  • Odds Ratio
  • Myocardial Infarction
  • Multivariate Analysis
 

Citation

APA
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ICMJE
MLA
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Owan, T. E., Roe, M. T., Messenger, J. C., Dai, D., & Michaels, A. D. (2012). Contemporary use of adjunctive thrombectomy during primary percutaneous coronary intervention for ST-elevation myocardial infarction in the United States. Catheter Cardiovasc Interv, 80(7), 1173–1180. https://doi.org/10.1002/ccd.24306
Owan, Theophilus E., Matthew T. Roe, John C. Messenger, David Dai, and Andrew D. Michaels. “Contemporary use of adjunctive thrombectomy during primary percutaneous coronary intervention for ST-elevation myocardial infarction in the United States.Catheter Cardiovasc Interv 80, no. 7 (December 1, 2012): 1173–80. https://doi.org/10.1002/ccd.24306.
Owan TE, Roe MT, Messenger JC, Dai D, Michaels AD. Contemporary use of adjunctive thrombectomy during primary percutaneous coronary intervention for ST-elevation myocardial infarction in the United States. Catheter Cardiovasc Interv. 2012 Dec 1;80(7):1173–80.
Owan, Theophilus E., et al. “Contemporary use of adjunctive thrombectomy during primary percutaneous coronary intervention for ST-elevation myocardial infarction in the United States.Catheter Cardiovasc Interv, vol. 80, no. 7, Dec. 2012, pp. 1173–80. Pubmed, doi:10.1002/ccd.24306.
Owan TE, Roe MT, Messenger JC, Dai D, Michaels AD. Contemporary use of adjunctive thrombectomy during primary percutaneous coronary intervention for ST-elevation myocardial infarction in the United States. Catheter Cardiovasc Interv. 2012 Dec 1;80(7):1173–1180.
Journal cover image

Published In

Catheter Cardiovasc Interv

DOI

EISSN

1522-726X

Publication Date

December 1, 2012

Volume

80

Issue

7

Start / End Page

1173 / 1180

Location

United States

Related Subject Headings

  • United States
  • Time Factors
  • Thrombectomy
  • Registries
  • Practice Patterns, Physicians'
  • Percutaneous Coronary Intervention
  • Patient Selection
  • Odds Ratio
  • Myocardial Infarction
  • Multivariate Analysis