Effect of thrombus aspiration on angiography and outcome in patients undergoing primary coronary angioplasty

Thrombus exerts a major impact on the performance and outcome of primary and rescue interventions in acute ST-elevation myocardial infarction. Although the optimal treatment of thrombotic lesions is still controversial, thrombus aspiration provides an effective method to achieve successful reperfusion during primary angioplasty. We compared clinical and angiographic outcomes in 286 patients with acute ST-elevation myocardial infarction undergoing primary percutaneous transluminal coronary angioplasty (PTCA) and thrombus aspiration with those who underwent conventional PTCA without thrombus aspiration. Thrombus aspiration during primary percutaneous coronary intervention in patients with high thrombus burden resulted in better Thrombolysis in Myocardial Infarction (TIMI) 3 flow in the infarct-related artery and helped achieve faster ST-segment resolution on the electrocardiogram compared with conventional angioplasty without thrombus aspiration

Gender differences in clinical characteristics, angiographic profile, and outcomes of left main coronary artery disease

Context: Left main coronary artery (LMCA) disease is associated with high morbidity and mortality in spite of advances in management. There is a paucity of data on the gender differences in LMCA disease. Aims: We aimed to study the clinical characteristics, angiographic profile, and outcome of coronary artery disease patients with significant LMCA disease. Settings and Design: This is a prospective observational study among patients with significant LMCA disease undergoing coronary angiography in a tertiary care center. Subjects and Methods: We compared clinical, angiographic characteristics among male and female patients with significant LMCA disease and followed up for 4 months. Statistical Analysis Used: Differences between the groups were compared with Student's t-test for parametric continuous variables. Chi-square test was applied for estimating the occurrence of categorical variables. Pearson's correlation coefficient was used to test the relationship between parameters. Results: Among 100 consecutive patients with LMCA disease, 70 were males and 30 were females. Chronic stable angina was the most common presentation. Distal LMCA was the most common site. Isolated LMCA disease was less compared to LMCA + multivessel disease. Coronary artery bypass grafting was the predominant management strategy. Mortality rates at 6 months were higher in females compared to males (20% vs. 3.3%). Conclusions: LMCA disease has mostly similar angiographic and clinical characteristics among males and females. LMCA disease is associated with high mortality in females compared to males