急性前壁心肌梗死应用DiverCE抽吸导管的有效性:TAPAFAMI试验Diver CE for thrombectomy in anterior myocardial infarction:A trial of thrombus aspiration during primary angioplasty for anterior myocardial infarction (TAPAFAMI)
颜红兵,朱小玲,艾辉,李南,高海,王健,李响,叶明,迟云鹏,张晓江
摘要(Abstract)：
目的评估急性前壁ST段抬高心肌梗死(STEMI)患者施行冠状动脉介入治疗(PCI)前应用DiverCE血栓抽吸导管的效果。方法单中心前瞻性评估发病<12h、TIMI血流0～1级的急性前壁STEMI患者施行直接PCI前应用DiverCE血栓抽吸导管的有效性。主要终点是PCI后1h内ST段回落程度。结果164例患者入选本研究。DiverCE组与常规PCI组的年龄(55.3±13.0岁比56.1±14.0岁)、男性(88%比87%)、糖尿病(30%比28%)、既往冠心病(24%比23%)、症状发作到直接PCI时间(348±175min比350±181min)和应用血小板膜糖蛋白Ⅱb/Ⅲa抑制剂(10%比9%)等基线资料均匹配。DiverCE组术后1h内ST段回落率(59%比38%)、即刻TIMI3级血流(96%比80%)、心肌呈色3级血流(70%比46%)和慢血流或无复流率(7%比17%)明显优于常规PCI组(P<0.05)。术后1个月临床结果显示,左心室射血分数(0.54±0.11比0.52±0.13)有改善趋势,死亡(4%比4%)、再次心肌梗死(2%比1%)、靶血管重建(1%比1%)和卒中(1%比1%)差异无统计学意义(P>0.05)。结论与常规PCI比较,在前壁STEMI患者施行支架术前应用DiverCE血栓抽吸导管可以降低远端栓塞、促进ST段回落并改善心肌灌注。
关键词(KeyWords)： 心肌梗死;支架;冠状动脉血栓形成;抽吸
基金项目(Foundation):
作者(Author): 颜红兵,朱小玲,艾辉,李南,高海,王健,李响,叶明,迟云鹏,张晓江
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