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. 2021 May;49(5):3000605211012611.
doi: 10.1177/03000605211012611.

Thrombus aspiration during primary percutaneous coronary intervention improved outcome in patients with STEMI and a large thrombus burden

Ning Bin  1 , Feifei Zhang  2 , Xuelian Song  2 , Yuetao Xie  2 , Meixue Jia  1 , Yi Dang  2
Affiliations

Thrombus aspiration during primary percutaneous coronary intervention improved outcome in patients with STEMI and a large thrombus burden

Ning Bin et al. J Int Med Res. 2021 May.

Abstract

Background: The benefit of thrombus aspiration (TA) during primary percutaneous coronary intervention (PPCI) to patients with ST-segment elevation myocardial infarction (STEMI) remains controversial. This study aimed to assess TA's impact on the outcome and prognosis for patients with STEMI and a large thrombus burden during PPCI.

Methods: This retrospective study evaluated consecutive patients with STEMI and a large thrombus burden (thrombolysis in myocardial infraction [TIMI] thrombus grade ≥4) who underwent conventional PPCI (n = 126) or PPCI + TA (n = 208) between February 2017 and January 2019. The procedure outcome and clinical prognosis were compared.

Results: Postprocedural vessel diameter was larger, and corrected TIMI frame count (cTFC) was lower in the PPCI + TA compared with the PPCI group. The proportion of postprocedural TIMI 3 flow was 83.3% in the PPC group and 94.2% in the PPCI+TA group. During the 12-month follow-up, no significant differences existed in the incidence of cardiac death, reinfarction, stent thrombosis, target vessel revascularization, or stroke.

Conclusion: Application of TA in patients with STEMI and a large thrombus burden during PPCI may improve the procedural outcome, but it showed no benefit on the clinical prognosis in the 12-month follow-up. Longer follow-up studies are needed to confirm TA's clinical implications in patients with STEMI.

Keywords: ST-segment elevation myocardial infarction; cardiac death; postprocedural vessel diameter; primary percutaneous coronary intervention; reinfarction; stent thrombosis; stroke; target vessel revascularization; thrombus aspiration; thrombus burden.

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Conflict of interest statement

Declaration of conflicting interest: The authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
Kaplan–Meier curves for cumulative probability of MACCE at 12 months for patients undergoing PPCI versus PPCI+TA before propensity score matching (a) and after propensity score matching (b) MACCE, major adverse cardiac cerebrovascular events; PPCI, primary percutaneous coronary intervention; TA, thrombus aspiration.
See this image and copyright information in PMC

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