TY - JOUR
T1 - GuardWire emboli protection device is associated with improved myocardial perfusion grade in saphenous vein graft intervention
AU - Exaire, Jose E.
AU - Brener, Sorin J.
AU - Ellis, Stephen G.
AU - Yadav, Jay S.
AU - Bhatt, Deepak L.
PY - 2004/12
Y1 - 2004/12
N2 - Background Use of emboli protection devices (EPD) during saphenous vein graft percutaneous coronary intervention (SVG-PCI) has been proven to reduce major adverse cardiac events (MACE). However, the impact of EPD on the microcirculation using Thrombolysis in Myocardial Infarction myocardial perfusion grade (TMP) has not been fully characterized. We sought to analyze TMP after SVG-PCI with and without EPD and determine its impact on inhospital MACE. Methods From August 2001 to December 2002, 305 patients had SVG-PCI suitable for EPD; 210 (69%) had an angiogram appropriate for TMP evaluation. Of those, 46 (22%) had an EPD (GuardWire, Medtronic, Minneapolis, Minn) deployed during the coronary intervention. Both groups were similar with regard to most demographic and clinical features. Results A TMP score of 2.5 or 3 was obtained in 98% of the EPD group versus 85% of the unprotected SVG-PCI (P = .01). There was a trend towards reduction in MACE when using EPD (15% vs 27%, respectively, P = .07). Peak postprocedural creatine kinase-MB was somewhat lower in the EPD group (6.03 ± 7.8 ng/mL vs 14.87 ± 42 ng/mL, P = .17) Patients with a TMP grade of 2.5 or 3 had a statistically significant reduction in MACE (OR 0.36, 95% CI 0.14-0.87, P = .02). Conclusions Compared with SVG-PCI without emboli protection, EPD significantly improved TMP and trended towards a reduction in MACE.
AB - Background Use of emboli protection devices (EPD) during saphenous vein graft percutaneous coronary intervention (SVG-PCI) has been proven to reduce major adverse cardiac events (MACE). However, the impact of EPD on the microcirculation using Thrombolysis in Myocardial Infarction myocardial perfusion grade (TMP) has not been fully characterized. We sought to analyze TMP after SVG-PCI with and without EPD and determine its impact on inhospital MACE. Methods From August 2001 to December 2002, 305 patients had SVG-PCI suitable for EPD; 210 (69%) had an angiogram appropriate for TMP evaluation. Of those, 46 (22%) had an EPD (GuardWire, Medtronic, Minneapolis, Minn) deployed during the coronary intervention. Both groups were similar with regard to most demographic and clinical features. Results A TMP score of 2.5 or 3 was obtained in 98% of the EPD group versus 85% of the unprotected SVG-PCI (P = .01). There was a trend towards reduction in MACE when using EPD (15% vs 27%, respectively, P = .07). Peak postprocedural creatine kinase-MB was somewhat lower in the EPD group (6.03 ± 7.8 ng/mL vs 14.87 ± 42 ng/mL, P = .17) Patients with a TMP grade of 2.5 or 3 had a statistically significant reduction in MACE (OR 0.36, 95% CI 0.14-0.87, P = .02). Conclusions Compared with SVG-PCI without emboli protection, EPD significantly improved TMP and trended towards a reduction in MACE.
UR - http://www.scopus.com/inward/record.url?scp=10644221873&partnerID=8YFLogxK
U2 - 10.1016/j.ahj.2004.06.015
DO - 10.1016/j.ahj.2004.06.015
M3 - Article
C2 - 15632885
AN - SCOPUS:10644221873
SN - 0002-8703
VL - 148
SP - 1003
EP - 1006
JO - American Heart Journal
JF - American Heart Journal
IS - 6
ER -