Incidence and clinical consequences of distal embolization on the coronary angiogram after percutaneous coronary intervention for ST-elevation myocardial infarction

Marieke L. Fokkema; Pieter J. Vlaar; Tone Svilaas; Mathijs Vogelzang; Diny Amo; Gilles F. H. Diercks; Albert J. H. Suurmeijer; Felix Zijlstra

doi:10.1093/eurheartj/ehp033

Incidence and clinical consequences of distal embolization on the coronary angiogram after percutaneous coronary intervention for ST-elevation myocardial infarction

Marieke L. Fokkema^*, Pieter J. Vlaar, Tone Svilaas, Mathijs Vogelzang, Diny Amo, Gilles F. H. Diercks, Albert J. H. Suurmeijer, Felix Zijlstra

^*Corresponding author for this work

Translational Immunology Groningen (TRIGR)

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133 Citations (Scopus)

Abstract

We investigated the incidence and sequelae of angiographically visible distal embolization (AVDE) after primary percutaneous coronary intervention (PCI) in ST-elevation myocardial infarction patients treated with aspirin, heparin, clopidogrel, and glycoprotein-IIb/IIIa inhibitors.

As part of TAPAS, AVDE was a predefined secondary endpoint. We compared angiographic and clinical characteristics, and outcomes of patients with and without AVDE after PCI. AVDE was present on 6.3% of 883 post-procedural angiograms. Angiographically visible distal embolization was associated with significantly worse outcomes, as expressed by lower myocardial blush grade, impaired ST-segment resolution, and higher enzyme levels (all P

In patients with triple anti-platelet therapy, the incidence of AVDE after PCI is low, compared with previous reports. Nevertheless, AVDE is associated with impaired myocardial reperfusion and poor outcome. Thrombus composition and size are related to AVDE after PCI.

Original language	English
Pages (from-to)	908-915
Number of pages	8
Journal	European Heart Journal
Volume	30
Issue number	8
DOIs	https://doi.org/10.1093/eurheartj/ehp033
Publication status	Published - Apr-2009

Keywords

ST-elevation myocardial infarction
Reperfusion
Angioplasty
Distal embolization
NO-REFLOW PHENOMENON
THROMBUS-ASPIRATION
PRIMARY ANGIOPLASTY
FOLLOW-UP
REPERFUSION
ABCIXIMAB
TRIAL
FLOW
METAANALYSIS
PREDICTOR

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Fokkema, M. L., Vlaar, P. J., Svilaas, T., Vogelzang, M., Amo, D., Diercks, G. F. H., Suurmeijer, A. J. H., & Zijlstra, F. (2009). Incidence and clinical consequences of distal embolization on the coronary angiogram after percutaneous coronary intervention for ST-elevation myocardial infarction. European Heart Journal, 30(8), 908-915. https://doi.org/10.1093/eurheartj/ehp033

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title = "Incidence and clinical consequences of distal embolization on the coronary angiogram after percutaneous coronary intervention for ST-elevation myocardial infarction",

abstract = "We investigated the incidence and sequelae of angiographically visible distal embolization (AVDE) after primary percutaneous coronary intervention (PCI) in ST-elevation myocardial infarction patients treated with aspirin, heparin, clopidogrel, and glycoprotein-IIb/IIIa inhibitors.As part of TAPAS, AVDE was a predefined secondary endpoint. We compared angiographic and clinical characteristics, and outcomes of patients with and without AVDE after PCI. AVDE was present on 6.3% of 883 post-procedural angiograms. Angiographically visible distal embolization was associated with significantly worse outcomes, as expressed by lower myocardial blush grade, impaired ST-segment resolution, and higher enzyme levels (all PIn patients with triple anti-platelet therapy, the incidence of AVDE after PCI is low, compared with previous reports. Nevertheless, AVDE is associated with impaired myocardial reperfusion and poor outcome. Thrombus composition and size are related to AVDE after PCI.",

keywords = "ST-elevation myocardial infarction, Reperfusion, Angioplasty, Distal embolization, NO-REFLOW PHENOMENON, THROMBUS-ASPIRATION, PRIMARY ANGIOPLASTY, FOLLOW-UP, REPERFUSION, ABCIXIMAB, TRIAL, FLOW, METAANALYSIS, PREDICTOR",

author = "Fokkema, {Marieke L.} and Vlaar, {Pieter J.} and Tone Svilaas and Mathijs Vogelzang and Diny Amo and Diercks, {Gilles F. H.} and Suurmeijer, {Albert J. H.} and Felix Zijlstra",

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doi = "10.1093/eurheartj/ehp033",

language = "English",

volume = "30",

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Incidence and clinical consequences of distal embolization on the coronary angiogram after percutaneous coronary intervention for ST-elevation myocardial infarction. / Fokkema, Marieke L.; Vlaar, Pieter J.; Svilaas, Tone et al.
In: European Heart Journal, Vol. 30, No. 8, 04.2009, p. 908-915.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Incidence and clinical consequences of distal embolization on the coronary angiogram after percutaneous coronary intervention for ST-elevation myocardial infarction

AU - Fokkema, Marieke L.

AU - Vlaar, Pieter J.

AU - Svilaas, Tone

AU - Vogelzang, Mathijs

AU - Amo, Diny

AU - Diercks, Gilles F. H.

AU - Suurmeijer, Albert J. H.

AU - Zijlstra, Felix

PY - 2009/4

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N2 - We investigated the incidence and sequelae of angiographically visible distal embolization (AVDE) after primary percutaneous coronary intervention (PCI) in ST-elevation myocardial infarction patients treated with aspirin, heparin, clopidogrel, and glycoprotein-IIb/IIIa inhibitors.As part of TAPAS, AVDE was a predefined secondary endpoint. We compared angiographic and clinical characteristics, and outcomes of patients with and without AVDE after PCI. AVDE was present on 6.3% of 883 post-procedural angiograms. Angiographically visible distal embolization was associated with significantly worse outcomes, as expressed by lower myocardial blush grade, impaired ST-segment resolution, and higher enzyme levels (all PIn patients with triple anti-platelet therapy, the incidence of AVDE after PCI is low, compared with previous reports. Nevertheless, AVDE is associated with impaired myocardial reperfusion and poor outcome. Thrombus composition and size are related to AVDE after PCI.

AB - We investigated the incidence and sequelae of angiographically visible distal embolization (AVDE) after primary percutaneous coronary intervention (PCI) in ST-elevation myocardial infarction patients treated with aspirin, heparin, clopidogrel, and glycoprotein-IIb/IIIa inhibitors.As part of TAPAS, AVDE was a predefined secondary endpoint. We compared angiographic and clinical characteristics, and outcomes of patients with and without AVDE after PCI. AVDE was present on 6.3% of 883 post-procedural angiograms. Angiographically visible distal embolization was associated with significantly worse outcomes, as expressed by lower myocardial blush grade, impaired ST-segment resolution, and higher enzyme levels (all PIn patients with triple anti-platelet therapy, the incidence of AVDE after PCI is low, compared with previous reports. Nevertheless, AVDE is associated with impaired myocardial reperfusion and poor outcome. Thrombus composition and size are related to AVDE after PCI.

KW - ST-elevation myocardial infarction

KW - Reperfusion

KW - Angioplasty

KW - Distal embolization

KW - NO-REFLOW PHENOMENON

KW - THROMBUS-ASPIRATION

KW - PRIMARY ANGIOPLASTY

KW - FOLLOW-UP

KW - REPERFUSION

KW - ABCIXIMAB

KW - TRIAL

KW - FLOW

KW - METAANALYSIS

KW - PREDICTOR

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DO - 10.1093/eurheartj/ehp033

M3 - Article

SN - 0195-668X

VL - 30

SP - 908

EP - 915

JO - European Heart Journal

JF - European Heart Journal

IS - 8

ER -

Incidence and clinical consequences of distal embolization on the coronary angiogram after percutaneous coronary intervention for ST-elevation myocardial infarction

Abstract

Keywords

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