Improved procedural results in coronary thrombosis are obtained with delayed percutaneous coronary interventions.

Abstract

We investigated the efficacy of percutaneous coronary intervention (PCI) in coronary thrombotic lesions according to the timing of the procedure. Eighty-two patients who underwent immediate PCI (IPCI) were compared to 24 patients who underwent PCI 4.9 3 days after the diagnostic catheterization [delayed PCI (DPCI)]. DPCI was associated with a lower rate of thrombus-related angiographic events (4% versus 27%; p < 0.03), including coronary embolism (0% versus 7%; p = NS), no-reflow phenomenon (0% versus 8%; p = NS), acute closure (0% versus 10%; p = NS), stent thrombosis (4% versus 1%; p = NS) and residual thrombus (0% versus 17%; p = 0.03). No differences were seen in the hospital clinical outcome, including non-fatal myocardial infarction (4% versus 9%; p = NS), death (4% versus 0%; p = NS) or major bleeding (4% versus 3%). Delayed PCI after pharmacological treatment is a safe and efficient strategy of treatment for coronary thrombus.