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

To assess the effect of manual thrombectomy on infarct size by cardiac magnetic resonance (CMR) and peak troponin I (TnI) levels. Use of manual thrombectomy during primary percutaneous coronary intervention (primary PCI) and its effect on infarct size is still debatable. 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. 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. 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.