Thrombus aspiration during primary percutaneous coronary intervention for preserving the index of microcirculatory resistance: a randomised study.
OBJECTIVE
We aimed to investigate whether thrombus aspiration could preserve the index of microcirculatory resistance (IMR) after primary percutaneous coronary intervention (PCI) in patients with ST-elevation myocardial infarction (STEMI).


RESULTS
Sixty-three patients with STEMI were randomised into two groups: primary PCI after thrombus aspiration (aspiration group, n=33) and primary PCI without thrombus aspiration (non-aspiration group, n=30). IMR was measured using a pressure-temperature sensor-tipped coronary wire. Echocardiography was performed at baseline and at six-month follow-up. No significant differences in baseline ejection fraction (EF, 47.3±8.5% vs. 49.5±7.8%, p=0.281) and baseline wall motion score index (WMSI, 1.45±0.31 vs. 1.37±0.27, p=0.299) were observed between the two groups. However, significant differences in IMR (23.5±10.2 U vs. 34.2±21.7 U, p=0.018), %E2%88%86EF (follow-up EF - baseline EF; 3.33±4.6% vs. 0.73±1.9%, p=0.005), and %E2%88%86WMSI (follow-up WMSI - baseline WMSI; -0.121±0.16 vs. -0.004±0.07, p=0.001) were observed between the two groups.


CONCLUSIONS
Thrombus aspiration as an adjunctive method to primary PCI for STEMI may preserve microvascular integrity and have beneficial effects on myocardial microcirculation.
Department of Cardiology, Inha University Hospital, Incheon, South Korea.
Seong-Ill
SI
Woo
Sang-Don
SD
Park
Dae-Hyeok
DH
Kim
Jun
J
Kwan
Sung-Hee
SH
Shin
Keum-Soo
KS
Park
Soo-Han
SH
Kim
Kyu-Yong
KY
Ko
Tae-Hyeon
TH
Hwang
Gwang-Seok
GS
Yoon
Woong-Gil
WG
Choi
Soo-Hyeon
SH
Kim
D000368:Aged; D003326:Coronary Circulation / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008833:Microcirculation / Q000502:physiology*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000517:prevention & control / Q000601:surgery*; D062645:Percutaneous Coronary Intervention / Q000379:methods; D013927:Thrombosis / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome