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Long-term clinical outcomes of thrombus aspiration in STEMI patients undergoing primary percutaneous coronary

Dilip Kumar1, Soumya Patra1, Arindam Pande1

  • 1Department of Cardiology, Medica Superspecialty Hospital Kolkata, West Bengal, India.

American Journal of Cardiovascular Disease
|July 21, 2020
PubMed

Insights

Thrombus aspiration before primary PCI in ST-segment elevation myocardial infarction (STEMI) did not show significant benefits in 1-year clinical outcomes or mortality rates compared to standard PCI.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Acute Coronary Syndromes

Background:

  • Clinical trials on thrombus aspiration in ST-segment elevation myocardial infarction (STEMI) before primary percutaneous coronary intervention (PCI) have yielded conflicting long-term outcome data.
  • There is a need to clarify the role and effectiveness of thrombosuction in contemporary STEMI management.

Purpose of the Study:

  • To evaluate the long-term clinical outcomes of thrombus aspiration versus standard primary PCI in STEMI patients.
  • To assess trends in the utilization of thrombosuction in STEMI patients undergoing primary PCI.

Main Methods:

  • A retrospective, single-center study of 241 STEMI patients undergoing primary PCI between January 2016 and December 2018.
  • Patients were divided into thrombus aspiration and standard primary PCI groups.
  • Primary endpoint was 1-year incidence of major adverse cardiac events (MACE); secondary endpoint was 1-year stent thrombosis.

Main Results:

  • No significant difference in 1-year MACE rates between thrombus aspiration (4.2%) and standard primary PCI (4.9%) groups (P=0.79).
  • All-cause mortality was slightly higher in the thrombus aspiration group (5.9%) versus standard PCI (4.1%), with similar cardiac death rates.
  • Definite stent thrombosis occurred in 0.8% of patients in both groups.

Conclusions:

  • Thrombus aspiration prior to primary PCI in STEMI patients offers no significant advantage regarding 1-year mortality or other clinical outcomes.
  • The routine use of thrombus aspiration in this setting may not be beneficial based on these findings.
Abstract

Keywords:
Percutaneous coronary interventionST-segment elevation myocardial infarctionthrombus aspiration

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