Abstract
Objectives: The aim of this study was to determine whether rheolytic thrombectomy (RT) before direct infarct artery stenting as compared with direct stenting (DS) alone results in improved myocardial reperfusion and clinical outcome in patients with acute myocardial infarction. Background: The routine removal of thrombus before infarct artery stenting is still a matter of debate. Methods: This is a multicenter, international, randomized, 2-arm, prospective study. Eligible patients were patients with acute myocardial infarction, angiographic evidence of thrombus grade 3 to 5, and a reference vessel diameter 99mTc-sestamibi infarct size. An α value = 0.05 achieved by both coprimary surrogate end points or an α value = 0.025 for a single primary surrogate end point would be considered evidence of statistical significance. Other surrogate end points were Thrombolysis In Myocardial Infarction (TIMI) flow grade 3, corrected TIMI frame count, and TIMI grade 3 blush. Clinical end points were a composite of major adverse cardiovascular events at 1, 6, and 12 months. Results: From December 2005 to September 2009, 501 patients were randomly allocated to RT before DS or to DS alone. The ST-segment resolution was more frequent in the RT arm as compared with the DS alone arm: 85.8% and 78.8%, respectively (p = 0.043), while no difference between groups were revealed in the other surrogate end points. The 6-month major adverse cardiovascular events rate was 11.2% in the thrombectomy arm and 19.4% in the DS alone arm (p = 0.011). The 1-year event-free survival rates were 85.2 ± 2.3% for the RT arm, and 75.0 ± 3.1% for the DS alone arm (p = 0.009). Conclusions: Although the primary efficacy end points were not met, the results of this study support the use of RT before infarct artery stenting in patients with acute myocardial infarction and evidence of coronary thrombus. (AngioJet Rheolytic Thrombectomy Before Direct Infarct Artery Stenting in Patients Undergoing Primary PCI for Acute Myocardial Infarction [JETSTENT]; NCT00275990)
| Original language | English |
|---|---|
| Pages (from-to) | 1298-1306 |
| Number of pages | 9 |
| Journal | Journal of the American College of Cardiology |
| Volume | 56 |
| Issue number | 16 |
| DOIs | |
| Publication status | Published - Oct 12 2010 |
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Keywords
- Coronary stenting
- Infarct artery
- Thrombectomy
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Comparison of angiojet rheolytic thrombectomy before direct infarct artery stenting with direct stenting alone in patients with acute myocardial infarction : The jetstent trial. / Migliorini, Angela; Stabile, Amerigo; Rodriguez, Alfredo E.; Gandolfo, Caterina; Rodriguez Granillo, Alfredo M.; Valenti, Renato; Parodi, Guido; Neumann, Franz Josef; Colombo, Antonio; Antoniucci, David.
In: Journal of the American College of Cardiology, Vol. 56, No. 16, 12.10.2010, p. 1298-1306.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Comparison of angiojet rheolytic thrombectomy before direct infarct artery stenting with direct stenting alone in patients with acute myocardial infarction
T2 - The jetstent trial
AU - Migliorini, Angela
AU - Stabile, Amerigo
AU - Rodriguez, Alfredo E.
AU - Gandolfo, Caterina
AU - Rodriguez Granillo, Alfredo M.
AU - Valenti, Renato
AU - Parodi, Guido
AU - Neumann, Franz Josef
AU - Colombo, Antonio
AU - Antoniucci, David
PY - 2010/10/12
Y1 - 2010/10/12
N2 - Objectives: The aim of this study was to determine whether rheolytic thrombectomy (RT) before direct infarct artery stenting as compared with direct stenting (DS) alone results in improved myocardial reperfusion and clinical outcome in patients with acute myocardial infarction. Background: The routine removal of thrombus before infarct artery stenting is still a matter of debate. Methods: This is a multicenter, international, randomized, 2-arm, prospective study. Eligible patients were patients with acute myocardial infarction, angiographic evidence of thrombus grade 3 to 5, and a reference vessel diameter 99mTc-sestamibi infarct size. An α value = 0.05 achieved by both coprimary surrogate end points or an α value = 0.025 for a single primary surrogate end point would be considered evidence of statistical significance. Other surrogate end points were Thrombolysis In Myocardial Infarction (TIMI) flow grade 3, corrected TIMI frame count, and TIMI grade 3 blush. Clinical end points were a composite of major adverse cardiovascular events at 1, 6, and 12 months. Results: From December 2005 to September 2009, 501 patients were randomly allocated to RT before DS or to DS alone. The ST-segment resolution was more frequent in the RT arm as compared with the DS alone arm: 85.8% and 78.8%, respectively (p = 0.043), while no difference between groups were revealed in the other surrogate end points. The 6-month major adverse cardiovascular events rate was 11.2% in the thrombectomy arm and 19.4% in the DS alone arm (p = 0.011). The 1-year event-free survival rates were 85.2 ± 2.3% for the RT arm, and 75.0 ± 3.1% for the DS alone arm (p = 0.009). Conclusions: Although the primary efficacy end points were not met, the results of this study support the use of RT before infarct artery stenting in patients with acute myocardial infarction and evidence of coronary thrombus. (AngioJet Rheolytic Thrombectomy Before Direct Infarct Artery Stenting in Patients Undergoing Primary PCI for Acute Myocardial Infarction [JETSTENT]; NCT00275990)
AB - Objectives: The aim of this study was to determine whether rheolytic thrombectomy (RT) before direct infarct artery stenting as compared with direct stenting (DS) alone results in improved myocardial reperfusion and clinical outcome in patients with acute myocardial infarction. Background: The routine removal of thrombus before infarct artery stenting is still a matter of debate. Methods: This is a multicenter, international, randomized, 2-arm, prospective study. Eligible patients were patients with acute myocardial infarction, angiographic evidence of thrombus grade 3 to 5, and a reference vessel diameter 99mTc-sestamibi infarct size. An α value = 0.05 achieved by both coprimary surrogate end points or an α value = 0.025 for a single primary surrogate end point would be considered evidence of statistical significance. Other surrogate end points were Thrombolysis In Myocardial Infarction (TIMI) flow grade 3, corrected TIMI frame count, and TIMI grade 3 blush. Clinical end points were a composite of major adverse cardiovascular events at 1, 6, and 12 months. Results: From December 2005 to September 2009, 501 patients were randomly allocated to RT before DS or to DS alone. The ST-segment resolution was more frequent in the RT arm as compared with the DS alone arm: 85.8% and 78.8%, respectively (p = 0.043), while no difference between groups were revealed in the other surrogate end points. The 6-month major adverse cardiovascular events rate was 11.2% in the thrombectomy arm and 19.4% in the DS alone arm (p = 0.011). The 1-year event-free survival rates were 85.2 ± 2.3% for the RT arm, and 75.0 ± 3.1% for the DS alone arm (p = 0.009). Conclusions: Although the primary efficacy end points were not met, the results of this study support the use of RT before infarct artery stenting in patients with acute myocardial infarction and evidence of coronary thrombus. (AngioJet Rheolytic Thrombectomy Before Direct Infarct Artery Stenting in Patients Undergoing Primary PCI for Acute Myocardial Infarction [JETSTENT]; NCT00275990)
KW - Coronary stenting
KW - Infarct artery
KW - Thrombectomy
UR - http://www.scopus.com/inward/record.url?scp=77957336023&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77957336023&partnerID=8YFLogxK
U2 - 10.1016/j.jacc.2010.06.011
DO - 10.1016/j.jacc.2010.06.011
M3 - Article
C2 - 20691553
AN - SCOPUS:77957336023
VL - 56
SP - 1298
EP - 1306
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
SN - 0735-1097
IS - 16
ER -