title: Clinical impact of thrombus aspiration during primary percutaneous coronary intervention: results from Korea Acute Myocardial Infarction Registry.
abstract: BACKGROUND
  The role of thrombus aspiration (TA) as an adjunct to primary percutaneous coronary intervention (PPCI) remains a matter of controversy.
  
  
  RESULTS
  A total of 2105 patients enrolled in the nationwide prospective Korea Acute Myocardial Infarction Registry, a cohort of 745 (35.4%) patients who underwent TA during PPCI was compared with 1360 (64.6%) patients who underwent conventional PCI without TA. Clinical outcomes at 12-months of overall enrolled patients and subgroups according to key variables were assessed using Cox regression models adjusted by propensity score. Although there was no significant difference among overall patients, in subgroup analyses, administration of glycoprotein (GP) IIb/IIIa inhibitor during PPCI [adjusted hazard ratio (HR) 0.329, 95% confidence interval (CI) 0.126-0.860, p=0.023] and left anterior descending (LAD) as a culprit lesion (adjusted HR 0.516, 95% CI 0.275-0.971, p=0.040) were the settings, in which TA was associated with a lower major adverse cardiac events (MACE) rate compared with non-TA.
  
  
  CONCLUSIONS
  Although TA does not improve clinical outcomes in overall patients who underwent PPCI, TA for LAD occlusion improves 12-month MACE. Furthermore, use of GP IIb/IIIa inhibitor with TA has a synergistic effect on clinical outcomes.
authors.affiliation: Chonnam National University Hospital, Gwangju, South Korea.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Hachinohe
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.forename: Shigeru
authors.initials: S
authors.lastname: Saito
authors.forename: Min Chol
authors.initials: MC
authors.lastname: Kim
authors.forename: Kyung Hoon
authors.initials: KH
authors.lastname: Cho
authors.forename: Khurshid
authors.initials: K
authors.lastname: Ahmed
authors.forename: Seung Hwan
authors.initials: SH
authors.lastname: Hwang
authors.forename: Min Goo
authors.initials: MG
authors.lastname: Lee
authors.forename: Doo Sun
authors.initials: DS
authors.lastname: Sim
authors.forename: Keun-Ho
authors.initials: KH
authors.lastname: Park
authors.forename: Ju Han
authors.initials: JH
authors.lastname: Kim
authors.forename: Young Joon
authors.initials: YJ
authors.lastname: Hong
authors.forename: Youngkeun
authors.initials: Y
authors.lastname: Ahn
authors.forename: Jung Chaee
authors.initials: JC
authors.lastname: Kang
authors.forename: Jong Hyun
authors.initials: JH
authors.lastname: Kim
authors.forename: Shung Chull
authors.initials: SC
authors.lastname: Chae
authors.forename: Young Jo
authors.initials: YJ
authors.lastname: Kim
authors.forename: Seung Ho
authors.initials: SH
authors.lastname: Hur
authors.forename: In Whan
authors.initials: IW
authors.lastname: Seong
authors.forename: Taek Jong
authors.initials: TJ
authors.lastname: Hong
authors.forename: Donghoon
authors.initials: D
authors.lastname: Choi
authors.forename: Myeong Chan
authors.initials: MC
authors.lastname: Cho
authors.forename: Chong Jin
authors.initials: CJ
authors.lastname: Kim
authors.forename: Ki Bae
authors.initials: KB
authors.lastname: Seung
authors.forename: Wook Sung
authors.initials: WS
authors.lastname: Chung
authors.forename: Yang Soo
authors.initials: YS
authors.lastname: Jang
authors.forename: Seung Woon
authors.initials: SW
authors.lastname: Rha
authors.forename: Jang Ho
authors.initials: JH
authors.lastname: Bae
authors.forename: Seung Jung
authors.initials: SJ
authors.lastname: Park
mesh_terms: D000368:Aged; D062906:Cardiac Catheters; D023381:Endpoint Determination; D005260:Female; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000628:therapy*; D062645:Percutaneous Coronary Intervention / Q000379:methods / Q000706:statistics & numerical data*; D012042:Registries / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013396:Suction / Q000379:methods; D017131:Thrombectomy / Q000379:methods* / Q000706:statistics & numerical data*; D013997:Time Factors; D016896:Treatment Outcome