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    The prognostic value of serum albumin levels on admission in patients with acute ST-segment elevation myocardial infarction undergoing a primary percutaneous coronary intervention
    (Lippincott Williams & Wilkins, 2013) Oduncu, Vecih; Erkol, Ayhan; Karabay, Can Y.; Kurt, Mustafa; Akgun, Taylan; Bulut, Mustafa; Pala, Selcuk
    Objectives Hypoalbuminemia is associated with a poor prognosis in patients with end-stage renal disease, chronic ischemic heart disease, heart failure (HF), and stroke. We aimed to investigate its prognostic value in patients with acute ST-segment elevation myocardial infarction (STEMI) treated by a primary percutaneous coronary intervention (p-PCI). Materials and methods We retrospectively enrolled 1706 patients with STEMI treated by p-PCI. We prospectively followed up the patients for a median duration of 40 months. Results On admission, hypoalbuminemia (< 3.5 g/dl) was present in 519 (30.4%) patients. The incidence of final TIMI grade 3 flow (84 vs. 91.4%, P < 0.001) was lower in the patients with hypoalbuminemia. In-hospital mortality (9.4 vs. 2%), HF (20.2 vs. 8.6%), and major bleeding (6 vs. 2.5%) rates were significantly higher in patients with hypoalbuminemia. However, in-hospital stroke and reinfarction rates were similar in both groups. At long-term follow-up (median duration: 42 months), all-cause mortality (23.3 vs. 8.4%, P < 0.001), reinfarction (11.6 vs. 7.7%, P= 0.013), stroke (2.6 vs. 1.1%, P = 0.031), and advanced HF (13.3 vs. 6.1%, P < 0.001) rates were significantly higher in patients with hypoalbuminemia. In the Cox proportional hazard model, hypoalbuminemia was determined as an independent predictor of long-term mortality [hazard ratio 2.98, 95% confidence interval 1.35-6.58, P = 0.007) and development of advanced HF (hazard ratio 2.96, 95% confidence interval 1.44-6.08, P = 0.003). Conclusion Hypoalbuminemia on admission is a strong independent predictor for long-term mortality and development of advanced HF in patients with STEMI undergoing p-PCI. Coron Artery Dis 24: 88-94 (C) 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins.
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    Thrombus aspiration in patients with ST elevation myocardial infarction : meta-analysis of 16 randomized trials
    (2015) Tanboğa, İbrahim Halil; Topçu, Selim; Aksakal, Enbiya; Kurt, Mustafa; Kaya, Ahmet; Oduncu, Vecih; Sevimli, Serdar
    Objective: The mortality rate is high in some patients undergoing primary percutaneous coronary intervention (PPCI) because of ineffective epicardial and myocardial perfusion. The use of thrombus aspiration (TA) might be beneficial in this group but there is contradictory evidence in current trials. Therefore, using PRISMA statement, we performed a meta-analysis that compares PPCI+TA with PPCI alone. Methods: Sixteen studies in which PPCI (n=5262) versus PPCI+TA (n=5256) were performed, were included in this meta-analysis. We calculated the risk ratio (RR) for epicardial and myocardial perfusion, such as the Thrombolysis In myocardial Infarction (TIMI) flow, myocardial blush grade (MBG) and stent thrombosis (ST) resolution (STR), and clinical outcomes, such as all-cause death, recurrent infarction (Re-MI), target vessel revascularization/target lesion revascularization (TVR/TLR), stent thrombosis (ST), and stroke. Results: Postprocedural TIMI-III flow frequency, postprocedural MBG II-III flow frequency, and postprocedural STR were significantly high in TA+PPCI compared with the PPCI alone group. However, neither all-cause mortality [6.6% vs. 7.4%, RR=0.903, 95% confidence interval (CI): 0.785-1.038, p=0.149] nor Re-MI (2.3% vs. 2.6%, RR=0.884, 95% CI: 0.693-1.127, p=0.319), TVR/TLR (8.2% vs. 8.0%, RR=1.028, 95% CI: 0.900-1.174, p=0.687), ST (0.93% vs. 0.90%, RR=1.029, 95% CI: 0.668-1.583, p=0.898), and stroke (0.5% vs. 0.5%, RR=1.073, 95% CI: 0.588-1.959, p=0.819) rates were comparable between the groups. Conclusion: This meta-analysis is the first updated analysis after publishing the 1-year result of the “Thrombus Aspiration during ST-Segment Elevation Myocardial Infarction” trial, and it showed that TA did not reduce the rate of all-cause mortality, Re-MI, TVR/TLR, ST, and stroke. (Anatol J Cardiol 2015; 15: 175-87)
  • Küçük Resim
    Öğe
    Thrombus aspiration in patients with ST elevation myocardial infarction: Meta-analysis of 16 randomized trials
    (Kare Publ, 2015) Tanboga, Ibrahim Halil; Topcu, Selim; Aksakal, Enbiya; Kurt, Mustafa; Kaya, Ahmet; Oduncu, Vecih; Sevimli, Serdar
    Objective: The mortality rate is high in some patients undergoing primary percutaneous coronary intervention (PPCI) because of ineffective epicardial and myocardial perfusion. The use of thrombus aspiration (TA) might be beneficial in this group but there is contradictory evidence in current trials. Therefore, using PRISMA statement, we performed a meta-analysis that compares PPCI+TA with PPCI alone. Methods: Sixteen studies in which PPCI (n=5262) versus PPCI+TA (n=5256) were performed, were included in this meta-analysis. We calculated the risk ratio (RR) for epicardial and myocardial perfusion, such as the Thrombolysis In myocardial Infarction (TIMI) flow, myocardial blush grade (MBG) and stent thrombosis (ST) resolution (STR), and clinical outcomes, such as all-cause death, recurrent infarction (Re-MI), target vessel revascularization/target lesion revascularization (TVR/TLR), stent thrombosis (ST), and stroke. Results: Postprocedural TIMI-III flow frequency, postprocedural MBG II-III flow frequency, and postprocedural STR were significantly high in TA+PPCI compared with the PPCI alone group. However, neither all-cause mortality [6.6% vs. 7.4%, RR=0.903, 95% confidence interval (CI): 0.785-1.038, p=0.149] nor Re-MI (2.3% vs. 2.6%, RR=0.884, 95% CI: 0.693-1.127, p=0.319), TVR/TLR (8.2% vs. 8.0%, RR=1.028, 95% CI: 0.900-1.174, p=0.687), ST (0.93% vs. 0.90%, RR=1.029, 95% CI: 0.668-1.583, p=0.898), and stroke (0.5% vs. 0.5%, RR=1.073, 95% CI: 0.588-1.959, p=0.819) rates were comparable between the groups. Conclusion: This meta-analysis is the first updated analysis after publishing the 1-year result of the Thrombus Aspiration during ST-Segment Elevation Myocardial Infarction trial, and it showed that TA did not reduce the rate of all-cause mortality, Re-MI, TVR/TLR, ST, and stroke.