Naslov
Reperfusion methods during primary PCI in patients presenting with persistent ST elevation: aspiration, balloons and medication.

Autori
Hadžibegović, Irzal ; Prvulović, Đeiti ; Vujeva, Božo ; Gabaldo, Krešimir

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, neobjavljeni rad, stručni

Skup
VI. kongres kardiologa i angiologa BiH

Mjesto i datum
Tuzla, Bosna i Hercegovina, 30.05.2013. - 01.06.2013

Vrsta sudjelovanja
Predavanje

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
reperfusion; PCI; ST elevation

Sažetak
Background and aim: Restoration of TIMI 3 flow in the infarct related artery within 120 minutes of first medical contact in a STEMI patient (90 minutes for large anterior wall STEMI) is widely adopted by the guidelines. Door-to-balloon time is accepted as a quality control tool that assesses efforts of in-hospital and cath lab delays minimization. Door-to-balloon remains in the STEMI terminology despite the fact that many STEMI patients achieve TIMI 3 flow without a balloon. We explored how TIMI 3 flow was established in our STEMI patients treated with primary PCI in a 2 year period. Patients and methods: Clinical and TIMI 3 flow data from 112 patients who received primary PCI during 2011 and 2012 in General hospital Slavonski Brod, Croatia, were analyzed. Median age was 66 years and 66% of patients were male. Diabetes was present in 21% of patients. Median pain to first medical contact time was 165 minutes. TIMI 3 flow was established or found on urgent angiography in 101 (90%) patients. Results: Patent infarct related artery with TIMI 3 flow was found by urgent angiography in 25 (22%) patients. TIMI 3 flow was achieved by an intravascular device (wire, balloon, or aspiration catheter) in 87 (78%) patients. TIMI 3 flow was restored by an aspiration catheter in 38% of patients, whereas balloon and wire alone established TIMI 3 flow in 32% and 8% of cases, respectively. Use of aspiration device resulted in higher frequencies of upfront GP IIb-IIIa inhibitors use. In-hospital mortality was 6%. Almost all patients with restored TIMI 3 flow and lethal in-hospital outcome received balloon inflation as a primary reperfusion method. Conclusion: Our experience showed that only one third of all STEMI patients treated with primary PCI achieved TIMI 3 flow after balloon inflation. New terminology for primary PCI network quality control should therefore be considered. Aspiration devise use was associated with higher frequency of upfront GP IIb/IIIa use, and also better patient outcome.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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