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

Henning Kelbaek; Christian J Terkelsen; Steffen Helqvist; Jens F Lassen; Peter Clemmensen; Lene Kløvgaard; Anne Kaltoft; Thomas Engstrøm; Hans E Bøtker; Kari Saunamäki; Lars R Krusell; Erik Jørgensen; Hans-Henrik T Hansen; Evald H Christiansen; Jan Ravkilde; Lars Køber; Klaus F Kofoed; Leif Thuesen

doi:10.1016/j.jacc.2007.10.047

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

Henning Kelbaek, Christian J Terkelsen, Steffen Helqvist, Jens F Lassen, Peter Clemmensen, Lene Kløvgaard, Anne Kaltoft, Thomas Engstrøm, Hans E Bøtker, Kari Saunamäki, Lars R Krusell, Erik Jørgensen, Hans-Henrik T Hansen, Evald H Christiansen, Jan Ravkilde, Lars Køber, Klaus F Kofoed, Leif Thuesen

Department of Clinical Medicine

115 Citations (Scopus)

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.

Original language	English
Journal	Journal of the American College of Cardiology
Volume	51
Issue number	9
Pages (from-to)	899-905
Number of pages	6
ISSN	0735-1097
DOIs	https://doi.org/10.1016/j.jacc.2007.10.047
Publication status	Published - 2008

Access to Document

10.1016/j.jacc.2007.10.047

Fingerprint

Dive into the research topics of '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'. Together they form a unique fingerprint.

Cite this

Kelbaek, H., Terkelsen, C. J., Helqvist, S., Lassen, J. F., Clemmensen, P., Kløvgaard, L., Kaltoft, A., Engstrøm, T., Bøtker, H. E., Saunamäki, K., Krusell, L. R., Jørgensen, E., Hansen, H-H. T., Christiansen, E. H., Ravkilde, J., Køber, L., Kofoed, K. F., & Thuesen, L. (2008). 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. Journal of the American College of Cardiology, 51(9), 899-905. https://doi.org/10.1016/j.jacc.2007.10.047

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. / Kelbaek, Henning; Terkelsen, Christian J; Helqvist, Steffen et al.

In: Journal of the American College of Cardiology, Vol. 51, No. 9, 2008, p. 899-905.

Research output: Contribution to journal › Journal article › Research › peer-review

Kelbaek, H, Terkelsen, CJ, Helqvist, S, Lassen, JF, Clemmensen, P, Kløvgaard, L, Kaltoft, A, Engstrøm, T, Bøtker, HE, Saunamäki, K, Krusell, LR, Jørgensen, E, Hansen, H-HT, Christiansen, EH, Ravkilde, J, Køber, L , Kofoed, KF & Thuesen, L 2008, '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', Journal of the American College of Cardiology, vol. 51, no. 9, pp. 899-905. https://doi.org/10.1016/j.jacc.2007.10.047

Kelbaek H, Terkelsen CJ, Helqvist S, Lassen JF, Clemmensen P, Kløvgaard L et al. 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. Journal of the American College of Cardiology. 2008;51(9):899-905. doi: 10.1016/j.jacc.2007.10.047

Kelbaek, Henning ; Terkelsen, Christian J ; Helqvist, Steffen et al. / 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. In: Journal of the American College of Cardiology. 2008 ; Vol. 51, No. 9. pp. 899-905.

@article{94451750118611df803f000ea68e967b,

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.",

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",

note = "Keywords: Angioplasty, Transluminal, Percutaneous Coronary; Atherectomy, Coronary; Coronary Thrombosis; Drug-Eluting Stents; Electrocardiography; Female; Humans; Male; Middle Aged; Myocardial Infarction; Treatment Outcome",

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",

number = "9",

}

TY - JOUR

T1 - 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

AU - Kelbaek, Henning

AU - Terkelsen, Christian J

AU - Helqvist, Steffen

AU - Lassen, Jens F

AU - Clemmensen, Peter

AU - Kløvgaard, Lene

AU - Kaltoft, Anne

AU - Engstrøm, Thomas

AU - Bøtker, Hans E

AU - Saunamäki, Kari

AU - Krusell, Lars R

AU - Jørgensen, Erik

AU - Hansen, Hans-Henrik T

AU - Christiansen, Evald H

AU - Ravkilde, Jan

AU - Køber, Lars

AU - Kofoed, Klaus F

AU - Thuesen, Leif

N1 - Keywords: Angioplasty, Transluminal, Percutaneous Coronary; Atherectomy, Coronary; Coronary Thrombosis; Drug-Eluting Stents; Electrocardiography; Female; Humans; Male; Middle Aged; Myocardial Infarction; Treatment Outcome

PY - 2008

Y1 - 2008

N2 - 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.

AB - 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.

U2 - 10.1016/j.jacc.2007.10.047

DO - 10.1016/j.jacc.2007.10.047

M3 - Journal article

C2 - 18308157

SN - 0735-1097

VL - 51

SP - 899

EP - 905

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

IS - 9

ER -