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Adjunctive thrombus aspiration versus conventional percutaneous coronary intervention in ST-elevation myocardial

Wouter J Kikkert1, Bimmer E Claessen, Nan van Geloven

  • 1Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|August 14, 2012
PubMed

Insights

Thrombus aspiration during primary percutaneous coronary intervention for ST-elevation myocardial infarction significantly reduced one-year mortality in a large patient cohort. This supports findings from the TAPAS trial, indicating improved survival benefits.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Clinical Research

Background:

  • Adjunctive thrombus aspiration in ST-elevation myocardial infarction (STEMI) improves reperfusion markers.
  • Evidence for improved survival with thrombus aspiration is primarily from the TAPAS trial.

Purpose of the Study:

  • To evaluate the impact of thrombus aspiration on mortality in STEMI patients undergoing primary percutaneous coronary intervention (PPCI).
  • To compare outcomes of thrombus aspiration versus conventional PCI in STEMI.

Main Methods:

  • Analysis of 3,750 STEMI patients treated with conventional PCI or thrombus aspiration (2001-2009).
  • Propensity score matching used to balance baseline characteristics between treatment groups (1,391 matched pairs).
  • Kaplan-Meier and Cox regression models assessed one-year mortality.

Main Results:

  • Thrombus aspiration was used in 40.1% of patients.
  • One-year mortality was 7.2% in the thrombus aspiration group versus 9.3% in the conventional PCI group (propensity-matched cohort).
  • Hazard ratio for one-year mortality with thrombus aspiration was 0.76 (95% CI: 0.59-0.99; P = 0.043), with consistent results in secondary analyses.

Conclusions:

  • Routine thrombus aspiration is associated with reduced one-year mortality in STEMI patients.
  • Findings support the survival benefit observed in the TAPAS trial.
  • Real-world data confirm the efficacy of thrombus aspiration in improving STEMI patient survival.
Abstract

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