Clinical effect of selective thrombus aspiration during primary percutaneous coronary intervention in patients with st-segment elevation myocardial infarction / 解放军医学杂志

ABSTRACT

Objective To assess impact of selective thrombus aspiration (TA) during primary percutaneous coronary intervention (pPCI) on long-term prognosis in patients with ST-segment elevation myocardial infarction (STEMI). Methods Between Jan. 2008 and Jan. 2014, a total of 2357 STEMI patients [429 in thrombus aspiration (TA) group and 1928 in routine percutaneous coronsry intorventim (PCI) group (control group)] were eligible for the study criteria and candidates for pPCI were enrolled in this study. The reflow of the involved vessel in pPCI procedure, stent thrombosis and major adverse cardiac events (MACE) were comparatively analyzed in the two groups during hospital stay and 12-month follow-up period. Results Although the success rate of TA procedure was significantly lower in TA group compared with that in control group (P0.001), both the TIMI flow grade ≥2 after TA procedure and stent implantation occurred more frequently in TA group than in control group (P0.05). The rates of MACE and stent thrombosis showed no difference between two groups during in-hospital and 12-month follow-up period (P>0.05). But the rates of total MACE and target vessel revascularization were significantly higher in control group than in TA group (P=0.04). Conclusion Selective TA procedure before primary PCI could improve final myocardial reperfusion, reduce the incidence of MACE and improve the 1-year clinical result for STEMI patients.