CHARACTERISTICS OF PATIENTS GOING FOR BAILOUT THROMBECTOMY DURING PRIMARY PERCUTANEOUS CORONARY INTERVENTION

Abstract

Objective: To study the baseline characteristics, angiographic variables andclinical outcomes of patients going for primary PCI(PPCI) who needed bailoutthrombectomy and compare them to patients going for ( PPCI) alone.

Methodology: This cross sectional study consisted of all patients diagnosed withacute STEMI according to the third universal definition of acute myocardialinfarction who underwent primary PCI (PPCI) at the Cardiology Department,Tanta University hospital, and Om Alkora cardiology center were included in thestudy from 1st March 2015 to 31st March 2017. We enrolled patients going forPPCI. They were admitted to the cathertization laboratory for PPCI. Patients whounderwent bailout thrombectomy constituted group 1 while rest of the patientsconstituted group 2. The primary outcome was a composite of death fromcardiovascular causes, recurrent myocardial infarction, cardiogenic shock, orNew York Heart Association (NYHA) class IV heart failure while the secondoutcome was stroke and renal impairment.

Results: Total of 830 patintes were included . Group 1 consisted of 130 patients(16%) and group 2 consisted of 700 patients.Women constituted the majority ofpatients in group 1; 54.6 vs 37.2% (p=0.003). In group 2, they weresignificantly more diabetic; 53 vs 44%, p=0.004 and more co-morbidities. Therewere more smokers in group 2; 80 vs 6 %, p<0.0001, more peripheral vasculardisease and liver disease 28 vs 10 %, 23 vs 1.5 %, p=0.015 and 0.001respectively. Patients in group 1 had more renal impairment during hospital stay;7 vs 4 %, p=0.034, and more patients developed stroke; 1.3 vs 0.7%, p=0.045.

Conclusion: Patients with STEMI who were admitted to the catheterizationlaboratory for PPCI, and needed bailout thrombectomy were more women, morediabetics and showed co-morbidities, they suffered more renal impairment andcerebrovascular events during hospitalization.