Frontiers in Cardiovascular Medicine (Sep 2022)

IntraCoronary Artery Retrograde Thrombolysis vs. Thrombus Aspiration in ST-Segment Elevation Myocardial Infarction: Study Protocol for a Randomized Controlled Trial

  • Mingzhi Shen,
  • Mingzhi Shen,
  • Jihang Wang,
  • Dongyun Li,
  • Xinger Zhou,
  • Xinger Zhou,
  • Yuting Guo,
  • Yuting Guo,
  • Wei Zhang,
  • Yi Guo,
  • Jian Wang,
  • Jie Liu,
  • Guang Zhao,
  • Shihao Zhao,
  • Jinwen Tian,
  • Jinwen Tian

DOI
https://doi.org/10.3389/fcvm.2022.928695
Journal volume & issue
Vol. 9

Abstract

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BackgroundType 2 diabetes (T2DM) is a major risk factor for myocardial infarction. Thrombus aspiration was considered a good way to deal with coronary thrombus in the treatment of acute myocardial infarction. However, recent studies have found that routine thrombus aspiration is not beneficial. This study is designed to investigate whether intracoronary artery retrograde thrombolysis (ICART) is more effective than thrombus aspiration or percutaneous transluminal coronary angioplasty (PTCA) in improving myocardial perfusion in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI).Methods/DesignIntraCoronary Artery Retrograde Thrombolysis (ICART) vs. thrombus aspiration or PTCA in STEMI trial is a single-center, prospective, randomized open-label trial with blinded evaluation of endpoints. A total of 286 patients with STEMI undergoing PPCI are randomly assigned to two groups: ICART and thrombus aspiration or PTCA. The primary endpoint is the incidence of >70% ST-segment elevation resolution. Secondary outcomes include distal embolization, myocardial blush grade, thrombolysis in myocardial infarction (TIMI) flow grade, and in-hospital bleeding.DiscussionThe ICART trial is the first randomized clinical trial (RCT) to date to verify the effect of ICART vs. thrombus aspiration or PTCA on myocardial perfusion in patients with STEMI undergoing PPCI.Clinical Trial Registration[https://www.chictr.org.cn/], identifier [ChiCTR1900023849].

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