Infarct size assessment by cardiac magnetic resonance after aspiration versus non aspiration thrombectomy assisted primary percutaneous coronary intervention

Abstract EN

Objectives: To assess the effect of manual thrombectomy on infarcl size by cardiac magnetic resonance (CMR) and peak troponin I (Tnl) levels.

Background: Use of manual thrombectomy during primary percutaneous coronary intervention (primary PCI) and its effect on infarct size is stiil debatable.

Methods: 70 patients (30 patients with thrombectomy and 40 patients without) who underwent primary PCI for ST-elevation myocardial infarction (STEMI) with adjunct intracoronary abciximab between January 2007 and August 2013 vvere included.

AH had CMR to assess their infarct size.

Résulte; No significant différence was observed in the baseüne characteristics between the two groups except for a higher baseüne Tnl (mean± standard déviation (SD) = 1 i,6±16.7 vs.2.4±7.9, median=3.3 vs.

0.23, P= 0.009) and more visible thrombus and or TIMl 0 flow (P=0.04) in the thrombectomy group.

No significant différence was found in infarct size assessed by CMR (median=16.2% vs.

16.49%, mean ±SD=18.1±13.2 vs.

16.45±11.7, P=0.6) or peak Tnl (median=46.5 vs.

36.1, mean=75.9±126 vs.

51.3±50.4, P=0.26) between the two groups.

A strong positive corrélation was found between Peak as well as Tnl at 24 hours (Tnl-24h) and CMR-determined infarct size (r= 0.5 and r=0.7 respectively, P< 0.001).

Tnl-24h (fi= 0.152, 95.0% Confidence Interval (CI) 0.116 - 0.187, P< 0.001) as well as final TIMl grade (5= -10,848, 95.0% CI -15.109 - -6.587, P< 0.001) predicts infarcl size.

Conclusions: In a rétrospective real world cohort of patients with STEMI, no différence was found in infarct size assessed by CMR or peak Tnl between the two groups with and without thrombectomy.

Tnl-24h as well as final TIMl flow predicts infarct size.