Journal article

Publication year: 2018

Pages: 240-249

Journal: Journal of Thrombosis and Thrombolysis

Volume number: 45

Issue number: 2

ISSN: 0929-5305

eISSN: 1573-742X

DOI Link: https://doi.org/10.1007/s11239-017-1601-2

Publisher: Springer

Abstract: 
The use of thrombus aspiration (TA) prior to primary percutaneous coronary intervention (PPCI) has undergone a radical change in intervention guidelines. The clinical implications, however, are still under scrutiny. This study investigated the clinical effects and outcome of TA before PPCI in patients with ST-segment elevation myocardial infarction (STEMI). Overall 1027 patients with STEMI were analyzed in this retrospective, propensity score-adjusted, multicenter study. The primary endpoints were in-hospital and long-term mortality. There were 418 patients in the TA group and 609 in the conventional PPCI group. The in-hospital mortality rate was significantly higher in the TA group (8.7 vs. 5.0%; P = 0.03). During long-term follow-up [median follow-up duration 689 days (IQR 405-959)] the mortality rates were similar (TA 14.3%, conventional PPCI 15.0%; P = 0.85). Survival analysis for the complete observation period revealed no significant benefit of TA [hazard ratio (HR) 1.12; 97.5% CI 0.90-0.71; P = 0.63]. There were also no significant differences between the groups in the following secondary endpoints: composite of cardiovascular death and non-fatal reinfarction at discharge (P = 0.39), post-PPCI thrombolysis in myocardial infarction flow-grade-3 (P = 0.14), left ventricular ejection fraction (P = 0.47), and non-fatal reinfarction during follow-up (P = 0.17). Rehospitalization rate (1.82 vs. 10.3%; P < 0.0001) and Canadian Cardiovascular Society (CCS) grading (P = 0.02) during follow-up were significantly lower in the TA group. In our cohort the in-hospital mortality rate was significantly higher for TA patients, but during long-term follow-up the mortality rates did not differ. The incidence of rehospitalization and CCS grading were lower in the TA-treated patients.

Harvard Citation style: Blumenstein, J., Kriechbaum, S., Leick, J., Meyer, A., Kim, W., Wolter, J., et al. (2018) Outcome of thrombus aspiration in STEMI patients: a propensity score-adjusted study, Journal of Thrombosis and Thrombolysis, 45(2), pp. 240-249. https://doi.org/10.1007/s11239-017-1601-2

APA Citation style: Blumenstein, J., Kriechbaum, S., Leick, J., Meyer, A., Kim, W., Wolter, J., Abu-Samra, M., Weipert, K., Bayer, M., Doerr, O., Walther, C., Hamm, C., Nef, H., Liebetrau, C., & Moellmann, H. (2018). Outcome of thrombus aspiration in STEMI patients: a propensity score-adjusted study. Journal of Thrombosis and Thrombolysis. 45(2), 240-249. https://doi.org/10.1007/s11239-017-1601-2