Infarct size assessment by cardiac magnetic resonance and peak troponin I after aspiration thrombectomy and intracoronary abciximab assisted primary percutaneous coronary intervention in a real-world cohort of patients with ST-segment elevation myocardial infarction: A single-center study

Abstract

Objectives: To assess the effect of manual thrombectomy on infarct size by cardiac magnetic resonance (CMR) and peak troponin I (TnI) levels. Background: Use of manual thrombectomy during primary percutaneous coronary intervention (primary PCI) and its effect on infarct size is still debatable. Methods: 70 patients (30 patients with thrombectomy and 40 without) who underwent primary PCI for ST-elevation myocardial infarction (STEMI) with adjunct intracoronary abciximab between January 2007 and August 2013 and had CMR afterwards were included. Results: No significant difference in the baseline characteristics except for a higher baseline TnI (11.6 ± 16.7 vs. 2.4 ± 7.9, P = 0.009) and more visible thrombus and or TIMI 0 flow (P = 0.04) in the thrombectomy group. No significant difference was found in infarct size assessed by CMR (18.1 ± 13.2 vs. 16.45 ± 11.7, P = 0.6) or peak TnI (75.9 ± 126 vs. 51.3 ± 50.4, P = 0.26) between the two groups. A moderate positive correlation was found between Peak as well as TnI at 24 hours (TnI-24 h) and CMR-determined infarct size (r = 0.5 and r = 0.7 respectively, P < 0.001). TnI-24 h (B = 0.152, 95.0% Confidence Interval (CI) 0.116–0.187, P < 0.001) as well as final TIMI grade (B = −10,848, 95.0% CI −15.109 to −6.587, P < 0.001) predicts infarct size. Conclusions: In a retrospective real world cohort of patients with STEMI, no difference was found in infarct size assessed by CMR or peak TnI between the groups with and without thrombectomy. TnI-24 h as well as final TIMI flow predicts infarct size.

Keywords

• STEMI
• Thrombectomy
• CMR