Impact of distal protection with filter-type device on long-term outcome after percutaneous coronary intervention for acute myocardial infarction: Clinical results with Filtrap®

Aim: although distal embolization during percutaneous coronary intervention (pci) for acute myocardial infarction (ami) deteriorates cardiac function,whether distal protection (dp) can improve prognosis is still controversial. we investigated whether a filter-type dp device,filtrap®,could improve long-term outcomes after pci for ami. method: we studied 164 patients (130 men,mean age: 65.7 years) who underwent pci. patients were divided into two groups based on the use of filtrap®. the occurrence of congestive heart failure (chf) and major adverse cardiac events (mace) defined as cardiac death,recurrent ami,and target vessel revascularization were compared. result: between dp (n=53,41 men,mean age: 65.5 years) and non-dp (n=111,89 men,mean age: 65.8 years) groups,although there was significantly greater plaque area in the dp group than in the non-dp group,there were no significant differences in coronary reperfusion flow after pci. interestingly,patients with chf in the non-dp group exhibited a higher ck level than those in the dp group. during a 2-year follow-up period,cumulative chf was significantly lower in the dp group than in the non-dp group (log-rank p=0.018),and there was no significant difference in the mace rate (log-rank p= 0.238). the use of dp device could not predict mace,but could predict chf by multivariate analysis (odds ratio =0.099,95% ci: 0.02– 0.42,p=0.005). conclusion: these results demonstrate that favorable clinical outcomes could be achieved by the filter- type dp device in ami,particularly in patients with chf. © 2016 japan atherosclerosis society.