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Effect of thrombus aspiration on postprocedural outcomes in elderly patients with acute ST-elevation myocardial

Ender Emre1, Ertan Ural2, Göksel Kahraman2

  • 1Department of Cardiology, Çorlu State Hospital, Tekirdağ, Turkey.

Geriatrics & Gerontology International
|August 7, 2015
PubMed

Insights

Thrombus aspiration during primary percutaneous coronary intervention for ST-elevation myocardial infarction in elderly patients showed no significant difference in postprocedural outcomes. This finding is crucial for managing older adults with STEMI.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Geriatric Cardiology

Background:

  • ST-elevation myocardial infarction (STEMI) is a critical condition requiring timely intervention.
  • Elderly patients with STEMI often present with comorbidities and a tendency for vasoconstriction, potentially impacting treatment outcomes.
  • Thrombus aspiration (TA) is a technique used during primary percutaneous coronary intervention (PCI) to remove thrombus, but its benefit in the elderly STEMI population is debated.

Purpose of the Study:

  • To evaluate the impact of thrombus aspiration during primary PCI on postprocedural outcomes in elderly patients (≥65 years) with STEMI.
  • To assess whether TA influences acute angiographic, electrocardiographic, and echocardiographic results in this specific patient group.

Main Methods:

  • A prospective study involving 124 elderly STEMI patients undergoing primary PCI.
  • Patients were divided into two groups: those who underwent TA and those who did not.
  • Comparison of baseline characteristics, acute angiographic, electrocardiographic, and echocardiographic parameters between the two groups.

Main Results:

  • Thrombus aspiration was performed in 33.8% of patients.
  • No significant differences were observed in baseline clinical characteristics or predischarge echocardiographic features (ejection fraction, wall motion index, septal E', E/E') between the TA(+) and TA(-) groups.
  • While acute angiographic and electrocardiographic results were slightly better in the TA group (e.g., corrected TIMI frame count, TIMI-3 flow, ST segment resolution), these differences did not reach statistical significance.

Conclusions:

  • Thrombus aspiration during primary PCI does not significantly improve postprocedural outcomes in elderly patients with STEMI.
  • The findings suggest that routine use of TA in this population may not confer additional benefits regarding the evaluated parameters.
Abstract

Keywords:
ST-elevation myocardial infarctionelderly patientspostprocedural outcomesprimary percutaneous coronary interventionthrombus aspiration

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