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1、EnhancedMyocardialEfficacyandRemoval byAspirationofLiberatedDebrisPresentedatAmericanCollegeofCardiologyScientificSessions2004PresentedbyDr.GreggW.StoneEMERALDTrialEndpoints:STresolution30minutespost-procedureInfarctsizeassessedbyTc-99msestamibiimagi
2、ngatdays5-14EMERALDTrialPresentedatACCScientificSessions2004505patientspresentingwithinsixhoursofchestpainonsetwith≥2mmSTelevationorleftbundlebranchblockandplanneduseofprimaryorrescuePCIRandomized,open-label,multicenterGuardWireDistalProtection0.028”
3、GuardWirePlusSystemn=252ControlNodistalprotectionn=246PresentedatACCScientificSessions2004EMERALDTrial%Visibledebriswasremovedin73%ofpatientsintheGuardWirearm.Therewasasignificantlyhighernumberofdiabeticpatientsinthecontrolarm(17.3%vs.7.5%,p=0.001).U
4、seofGPIIb/IIIainhibitorswas82.9%and83.5%intheGuardWireandControlarms,respectively.Majoradversecardiacevents(MACE)at30dayswassimilarinbothgroups,aswerethecomponentsofMACE:death(2.1%vs.2.9%,p=0.77),heartfailure(2.1%vs.0.4%,p=0.12),newonsethypotension(1
5、1.1%each),andreadmissionforleftventricularfailure(0.8%vs.0%,p=0.25).MACEat30Daysp=0.79PresentedatACCScientificSessions2004EMERALDTrial%Post-procedureepicardialflowdidnotdifferbetweengroups,asassessedusingTIMIgrade3floworTIMIframecount.Myocardialblush
6、grade3trendedhigherintheGuardWirearm.GuardWireControlPost-ProcedureTIMIGrade3Flowp=0.36Post-ProcedureTIMIFrameCountp=0.48GuardWireControlGuardWireControlPost-ProcedureMyocardialBlush3p=0.13PresentedatACCScientificSessions2004EMERALDTrial%Thefrequency
7、ofcompleteSTresolution(≥70%)30minutespost-proceduredidnotdifferbetweenthetreatmentarms,nordidmeanSTresolution.Theothercoprimaryendpoint,infarctsize,alsodidnotdifferbetweentreatmentgroups.GuardWireControlCompleteSTResolution(≥70%)30MinutesPost-Procedu
8、rep=0.77MeanSTResolutionp=0.39GuardWireControlGuardWireControlInfarctSizep=0.09AmongpatientswithSTEMI,useofthedistalprotectionGuardWiredevicewasnotassociatedwithanimprovementintheprimaryendpointsofpost-procedureSTresolutionorfinalinfarctsize.Despitet
