Premium
Multicenter and all‐comers validation of a score to select patients for manual thrombectomy, the DDTA score
Author(s) -
Cordero Alberto,
CidAlvarez Belén,
Alegría Eduardo,
FernándezCisnal Agustín,
Escribano David,
Bautista Jenniffer,
Juskova Maria,
Trillo Ramiro,
BertomeuGonzalez Vicente,
Ferreiro José Luis
Publication year - 2021
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.29689
Subject(s) - timi , medicine , mace , conventional pci , percutaneous coronary intervention , clinical endpoint , cohort , framingham risk score , incidence (geometry) , cardiology , surgery , myocardial infarction , randomized controlled trial , physics , disease , optics
Background Routine manual thrombectomy (MT) is not recommended in primary percutaneous coronary intervention (P‐PCI) but it is performed in many procedures. The objective of our study was validating the DDTA score, designed for selecting patients who benefit most from MT. Methods Observational and multicenter study of all consecutive patients undergoing P‐PCI in five institutions. Results were compared with the design cohort and the performance of the DDTA was analyzed in all patients. Primary end‐point of the analyses was TIMI 3 after MT; secondary endpoints were final TIMI 3, no‐reflow incidence, in‐hospital mortality and in‐hospital major cardiovascular events (MACE). In‐hospital prognosis was assessed by the Zwolle risk score. Results Three hundred forty patients were included in the validation cohort and no differences were observed as compared to the design cohort (618 patients) except for lower use of MT and higher IIb/IIIa inhibitors or drug‐eluting stents. The probability of TIMI 3 after MT decreased as delay to P‐PCI was higher. If DDTA score, MT was associated to TIMI 3 after MT (OR: 4.11) and final TIMI 3 (OR: 2.44). There was a linear and continuous relationship between DDTA score and all endpoints. DDTA score ≥ 4 was independently associated to lower no‐reflow, in‐hospital MACE or mortality. The lowest incidence of in‐hospital mortality or MACE was in patients who had DDTA score ≥ 4 and Zwolle risk score 0–3. Conclusions MT is associated to higher rate of final TIMI3 in patients with the DDTA score ≥ 4. Patients with DDTA score ≥ 4 had lower no‐reflow and in‐hospital complications.