Thrombus Aspiration in Primary PCI Has No Effect on Outcomes
(HealthDay News) – The use of manual or mechanical thrombus aspiration (TA) in adjunct to primary percutaneous coronary intervention (PPCI) does not affect the two-year incidence of major adverse cardiac events in patients with acute ST-segment elevation myocardial infarction (STEMI), according to a study published in the May 1 issue of Catheterization & Cardiovascular Interventions.
To investigate the long-term clinical outcome after TA in adjunct to PPCI for STEMI, Maarten A. Vink, MD, from Onze Lieve Vrouwe Gasthuis in Amsterdam, and colleagues analyzed data from the Paclitaxel-eluting versus Conventional Stent in Myocardial Infarction with ST-segment Elevation (PASSION) trial, in which 619 patients with STEMI were randomly allocated to receive a paclitaxel-eluting stent or a bare-metal stent. Three hundred eleven patients (50.2%) underwent TA during PPCI.
The researchers found complete follow-up data available for 96.6% of participants (598 patients). There was no significant difference in the cumulative incidence of the combined outcome measures of cardiac death, recurrent myocardial infarction, or target lesion revascularization between the two groups. The cumulative incidence was 13% in the TA group and 13.5% in the conventional PPCI group (hazard ratio, 0.96; P=0.84). There was no significant difference in the event rate between the treatment groups, after adjusting for propensity score.
"In this post-hoc analysis of the PASSION trial, TA in adjunct to PPCI did not affect rates of major adverse cardiac events at two years follow-up, as compared with conventional PPCI," the authors write.