Thrombus aspiration in patients with ST-elevation myocardial infarction: results of a national registry of interventional cardiology

BMC Cardiovasc Disord. 2018 Apr 24;18(1):69. doi: 10.1186/s12872-018-0794-4.

Abstract

Background: We aimed to evaluate the impact of thrombus aspiration (TA) during primary percutaneous coronary intervention (P-PCI) in 'real-world' settings.

Methods: We performed a retrospective study, using data from the National Registry of Interventional Cardiology (RNCI 2006-2012, Portugal) with ST-elevation myocardial infarction (STEMI) patients treated with P-PCI. The primary outcome, in-hospital mortality, was analysed through adjusted odds ratio (aOR) and 95% confidence intervals (95%CI).

Results: We assessed data for 9458 STEMI patients that undergone P-PCI (35% treated with TA). The risk of in-hospital mortality with TA (aOR 0.93, 95%CI:0.54-1.60) was not significantly decreased. After matching patients through the propensity score, TA reduced significantly the risk of in-hospital mortality (OR 0.58, 95%CI:0.35-0.98; 3500 patients).

Conclusions: The whole cohort data does not support the routine use of TA in P-PCI, but the results of the propensity-score matched cohort suggests that the use of selective TA may improve the short-term risks of STEMI.

Keywords: Angioplasty; Mortality; Portugal; Primary PCI; Thrombectomy; Thrombus aspiration.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Aged
  • Coronary Thrombosis / diagnosis
  • Coronary Thrombosis / mortality
  • Coronary Thrombosis / surgery*
  • Female
  • Hospital Mortality
  • Humans
  • Male
  • Middle Aged
  • Percutaneous Coronary Intervention* / adverse effects
  • Percutaneous Coronary Intervention* / mortality
  • Portugal
  • Protective Factors
  • Registries
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • ST Elevation Myocardial Infarction / diagnosis
  • ST Elevation Myocardial Infarction / mortality
  • ST Elevation Myocardial Infarction / surgery*
  • Thrombectomy* / adverse effects
  • Thrombectomy* / mortality
  • Time Factors
  • Treatment Outcome