Premium
No long‐term clinical benefit from manual aspiration thrombectomy in ST‐elevation myocardial infarction patients. Data from NRDES registry
Author(s) -
Siudak Zbigniew,
Mielecki Waldemar,
Dziewierz Artur,
Rakowski Tomasz,
Legutko Jacek,
Bartuś Stanisław,
Bryniarski Krzysztof L.,
Partyka Łukasz,
Dudek Dariusz
Publication year - 2014
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.25572
Subject(s) - medicine , conventional pci , myocardial infarction , subgroup analysis , stroke (engine) , propensity score matching , thrombolysis , clinical endpoint , randomized controlled trial , surgery , cardiology , meta analysis , mechanical engineering , engineering
Background Current STEMI guidelines recommend thrombectomy should be considered during primary PCI. Multiple data from randomized clinical trials, registries, and metanalysis have confirmed the efficacy of thrombectomy in terms of surrogate endpoints like better myocardial perfusion, less pronounced distal embolization, and conflicting results on lower all‐cause mortality. Our aim was to analyze long‐term outcome of STEMI patients treated with manual thrombectomy during primary PCI in a contemporary national registry. Methods There were 13 catheterization laboratories in Poland that enrolled patients in NRDES Registry. Patients were divided into two groups: those that were treated with manual thrombectomy for their primary PCI vs. those who were not. Results There were altogether 2,686 patients enrolled in the NRDES Registry of whom 1,763 were diagnosed with STEMI (66%). Aspiration thrombectomy was used in 673 of these cases (38%) and 1,090 (62%) patients were treated without thrombectomy during the index primary PCI. Overall mortality at 1 year was 11.03% in thrombectomy and 7.46% in no thrombectomy group respectively ( P = 0.0292 which became insignificant after propensity score matching adjustment P = 0.613). Specific subgroup analyses revealed that there was no benefit from aspiration thrombectomy in neither subgroup. Conclusions Manual aspiration thrombectomy in patients undergoing primary PCI for STEMI was not associated with improved long‐term 1‐year clinical outcome. Subgroup analysis did not reveal any specific setting in which thrombectomy would be clinically superior. © 2014 Wiley Periodicals, Inc.