title: Outcomes 1 year after thrombus aspiration for myocardial infarction.
abstract: BACKGROUND
  Routine intracoronary thrombus aspiration before primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI) has not been proved to reduce short-term mortality. We evaluated clinical outcomes at 1 year after thrombus aspiration.
  
  
  METHODS
  We randomly assigned 7244 patients with STEMI to undergo manual thrombus aspiration followed by PCI or to undergo PCI alone, in a registry-based, randomized clinical trial. The primary end point of all-cause mortality at 30 days has been reported previously. Death from any cause at 1 year was a prespecified secondary end point of the trial.
  
  
  RESULTS
  No patients were lost to follow-up. Death from any cause occurred in 5.3% of the patients (191 of 3621 patients) in the thrombus-aspiration group, as compared with 5.6% (202 of 3623) in the PCI-only group (hazard ratio, 0.94; 95% confidence interval [CI], 0.78 to 1.15; P=0.57). Rehospitalization for myocardial infarction at 1 year occurred in 2.7% and 2.7% of the patients, respectively (hazard ratio, 0.97; 95% CI, 0.73 to 1.28; P=0.81), and stent thrombosis in 0.7% and 0.9%, respectively (hazard ratio, 0.84; 95% CI, 0.50 to 1.40; P=0.51). The composite of death from any cause, rehospitalization for myocardial infarction, or stent thrombosis occurred in 8.0% and 8.5% of the patients, respectively (hazard ratio, 0.94; 95% CI, 0.80 to 1.11; P=0.48). The results were consistent across all the major subgroups, including grade of thrombus burden and coronary flow before PCI.
  
  
  CONCLUSIONS
  Routine thrombus aspiration before PCI in patients with STEMI did not reduce the rate of death from any cause or the composite of death from any cause, rehospitalization for myocardial infarction, or stent thrombosis at 1 year. (Funded by the Swedish Research Council and others; TASTE ClinicalTrials.gov number, NCT01093404.).
authors.affiliation: From the Department of Medical Sciences, Cardiology Section, and Uppsala Clinical Research Center, Uppsala University, Uppsala (B.L., O.O., S.K.J.), Department of Cardiology, Örebro University Hospital, Örebro (O.F., F.C.), Department of Coronary Heart Disease, Skane University Hospital, Clinical Sciences Section, Lund University, Lund (G.K.O., M.G., A.L.), Department of Cardiology, Karolinska Institutet, Södersjukhuset (P.A., O.C.), and Department of Cardiology, Karolinska Institutet, Danderyd (R.L.), Stockholm, Department of Cardiology, Umeå University Hospital, Umeå (J.A.), Section of Cardiology, Kalmar County Hospital and Linnaeus University, Kalmar (J.C.), Department of Cardiology, Halmstad Hospital, Halmstad (P.H.), Department of Cardiology, Sahlgrenska University Hospital, Gothenburg (D.I., J.O., E.O.), Department of Cardiology, Skaraborgs Hospital, Skövde (A.K.), Department of Radiology, Ryhov Hospital, Jönköping (V.P.), Department of Cardiology, Linköping University Hospital, Linköping (T.T.), and Department of Radiology, Mälarsjukhuset, Eskilstuna (E.Z.) - all in Sweden; Department of Cardiology and Cardiovascular Research Center, Landspitali University Hospital, Reykjavik, Iceland (T.G.); and the Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark (M.M.).
authors.forename: Bo
authors.initials: B
authors.lastname: Lagerqvist
authors.forename: Ole
authors.initials: O
authors.lastname: Fröbert
authors.forename: Göran K
authors.initials: GK
authors.lastname: Olivecrona
authors.forename: Thórarinn
authors.initials: T
authors.lastname: Gudnason
authors.forename: Michael
authors.initials: M
authors.lastname: Maeng
authors.forename: Patrik
authors.initials: P
authors.lastname: Alström
authors.forename: Jonas
authors.initials: J
authors.lastname: Andersson
authors.forename: Fredrik
authors.initials: F
authors.lastname: Calais
authors.forename: Jörg
authors.initials: J
authors.lastname: Carlsson
authors.forename: Olov
authors.initials: O
authors.lastname: Collste
authors.forename: Matthias
authors.initials: M
authors.lastname: Götberg
authors.forename: Peter
authors.initials: P
authors.lastname: Hårdhammar
authors.forename: Dan
authors.initials: D
authors.lastname: Ioanes
authors.forename: Anders
authors.initials: A
authors.lastname: Kallryd
authors.forename: Rickard
authors.initials: R
authors.lastname: Linder
authors.forename: Anders
authors.initials: A
authors.lastname: Lundin
authors.forename: Jacob
authors.initials: J
authors.lastname: Odenstedt
authors.forename: Elmir
authors.initials: E
authors.lastname: Omerovic
authors.forename: Verner
authors.initials: V
authors.lastname: Puskar
authors.forename: Tim
authors.initials: T
authors.lastname: Tödt
authors.forename: Eva
authors.initials: E
authors.lastname: Zelleroth
authors.forename: Ollie
authors.initials: O
authors.lastname: Östlund
authors.forename: Stefan K
authors.initials: SK
authors.lastname: James
mesh_terms: D000368:Aged; D002423:Cause of Death; D003131:Combined Modality Therapy; D023903:Coronary Restenosis; D003328:Coronary Thrombosis / Q000628:therapy*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D010359:Patient Readmission; D062645:Percutaneous Coronary Intervention; D013396:Suction