@article{292d1082113046e29935f9b6e1471164,
title = "Randomized comparison of distal protection versus conventional treatment in primary percutaneous coronary intervention: the drug elution and distal protection in ST-elevation myocardial infarction (DEDICATION) trial.",
abstract = "OBJECTIVES: The purpose of this study was to evaluate the use of distal protection during percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) in native coronary vessels. BACKGROUND: Embolization of material from the infarct-related lesion during PCI may result in impaired myocardial perfusion and worsen the prognosis. Previous attempts to protect the microcirculation during primary PCI have had conflicting results. METHODS: We randomly assigned 626 patients with STEMI referred within 12 h to have PCI performed with (n = 312) or without (n = 314) distal protection. The primary end point was complete (>or=70%) ST-segment resolution detected by continuous ST-segment monitoring. Blood levels of troponin-T and creatine kinase-MB were monitored before and after the procedure, and echocardiographic determination of the left ventricular wall motion index (WMI) was performed before discharge. RESULTS: Patients were well matched in terms of demographic and angiographic baseline characteristics. There was no significant difference in the occurrence of the primary end point (76% vs. 72%, p = 0.29), no difference in maximum troponin-T (4.8 microg/l and 5.0 microg/l, p = 0.87) or maximum creatine kinase-MB (185 microg/l and 184 microg/l, p = 0.99), and no difference in median WMI (1.70 vs. 1.70, p = 0.35). The rate of major adverse cardiac and cerebral events (MACCE) 1 month after PCI was 5.4% with distal protection and 3.2% with conventional treatment (p = 0.17). CONCLUSIONS: The routine use of distal protection by a filterwire system during primary PCI does not seem to improve microvascular perfusion, limit infarct size, or reduce the occurrence of MACCE.",
keywords = "Angioplasty, Transluminal, Percutaneous Coronary, Atherectomy, Coronary, Coronary Thrombosis, Drug-Eluting Stents, Electrocardiography, Female, Humans, Male, Middle Aged, Myocardial Infarction, Treatment Outcome",
author = "Henning Kelbaek and Terkelsen, {Christian J} and Steffen Helqvist and Lassen, {Jens F} and Peter Clemmensen and Lene Kl{\o}vgaard and Anne Kaltoft and Thomas Engstr{\o}m and B{\o}tker, {Hans E} and Kari Saunam{\"a}ki and Krusell, {Lars R} and Erik J{\o}rgensen and Hansen, {Hans-Henrik T} and Christiansen, {Evald H} and Jan Ravkilde and Lars K{\o}ber and Kofoed, {Klaus F} and Leif Thuesen",
year = "2008",
doi = "10.1016/j.jacc.2007.10.047",
language = "English",
volume = "51",
pages = "899--905",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",
publisher = "Elsevier",
}