Contemporary outcomes of rescue percutaneous coronary intervention for acute myocardial infarction: comparison with primary angioplasty and the role of distal protection devices (EMERALD trial).
Publication/Presentation Date
6-1-2008
Abstract
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.
Volume
155
Issue
6
First Page
1090
Last Page
1096
ISSN
1097-6744
Published In/Presented At
Dangas, G., Stone, G. W., Weinberg, M. D., Webb, J., Cox, D. A., Brodie, B. R., Krucoff, M. W., Gibbons, R. J., Lansky, A. J., Mehran, R., & EMERALD Investigators (2008). Contemporary outcomes of rescue percutaneous coronary intervention for acute myocardial infarction: comparison with primary angioplasty and the role of distal protection devices (EMERALD trial). American heart journal, 155(6), 1090–1096. https://doi.org/10.1016/j.ahj.2007.12.003
Disciplines
Medicine and Health Sciences
PubMedID
18513524
Department(s)
Department of Medicine
Document Type
Article