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Background: The clinical impact of intracoronary thrombus aspiration (TA) during primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI) is unclear. We investigated to evaluate whether TA during primary PCI reduces one-year mortality.  Methods: From the Korea Acute Myocardial Infarction Registry-National Institute of Health, 3749 patients with STEMI who were undergoing primary PCI within 12 hours (60.8±12.9 years, 18.7% women) and shown pre-procedural Thrombolysis In Myocardial Infarction (TIMI) flow 0, 1 in coronary angiography were enrolled between November 2011 and November 2015 during one-year follow up. The patients were divided into two groups according to TA during primary PCI: PCI with TA (n=1630) and PCI alone (n=2119). The primary end-point was major adverse cardiac events (MACE), defined as the composite of cardiovascular death (CVD), stroke or recurrent MI at one-year. The secondary efficacy end-point were all-cause of mortality and CVD at one-year.  Results: PCI with TA did not reduce the risk of MACE (OR: 0.598, 95% CI: 0.737-1.160, p=0.499), all-cause mortality (OR: 0.898, 95% CI: 0.705-1.144, p=0.383) and CVD (OR: 0.893, 95% CI: 0.683-1.168, p=0.408) in all patients during one-year follow up. The trend did not change after propensity score matching. In subgroup analysis, there was no efficacy of clinical outcome during one-year follow up.  Conclusions: Primary PCI with TA did not reduce MACE and all-cause mortality among patients with STEMI and pre-procedural TIMI flow 0,1 during one-year follow up.

clinical cardiology and cardiovascular interventions

Impact of Thrombus Aspiration one-year Cardiac Mortality During Primary PCI in STEMI Patients with total Occlusion; from Korea Acute Myocardial Infarction Registry National Institute of Health