title: Effect of coronary thrombus aspiration during primary percutaneous coronary intervention on one-year survival (from the FAST-MI 2010 registry).
abstract: Results from randomized trials evaluating thrombus aspiration (TA) in patients with ST-elevation myocardial infarction (STEMI) are conflicting. We assessed 1-year survival in STEMI patients participating in the French Registry of Acute ST-Elevation and non-ST-Elevation Myocardial Infarction (FAST-MI) 2010 according to the use of TA during primary percutaneous coronary intervention (PCI). FAST-MI 2010 is a nationwide French registry that included 4,169 patients with acute myocardial infarction at the end of 2010 in 213 centers. Of those, 2,087 patients had STEMI, of whom 1,538 had primary PCI, with TA used in 671 (44%). Patients with TA were younger (61 ± 13.5 vs 63 ± 14 years), with a similar risk score of the Global Registry of Acute Coronary Events (140 ± 31 vs 143 ± 34) and a shorter median time from symptom onset (245 vs 285 minutes); location of acute myocardial infarction, history of myocardial infarction, PCI, or coronary artery bypass surgery did not differ significantly. Thirty-day mortality was 2.1% versus 2.1% (adjusted p = 0.18), and the rate of 1-year survival was 95.5% versus 94.8%. Using fully adjusted Cox multivariate analysis, hazard ratio for 1-year death was 1.13 (95% confidence interval 0.66 to 1.94). After propensity score matching (480 patients per group), 1-year survival was also similar with both strategies. In a real-world setting of patients admitted with STEMI, the use of TA during primary PCI was not associated with improved 1-year survival.
authors.affiliation: Departement of Cardiology, European Hospital of Georges Pompidou, Assistance Publique des Hôpitaux de Paris (AP-HP), University Paris Descartes, Paris, France; INSERM U-970, Paris, France. Electronic address: etiennepuymirat@yahoo.fr.
authors.forename: Etienne
authors.initials: E
authors.lastname: Puymirat
authors.affiliation: Departement of Cardiology, European Hospital of Georges Pompidou, Assistance Publique des Hôpitaux de Paris (AP-HP), University Paris Descartes, Paris, France.
authors.forename: Nadia
authors.initials: N
authors.lastname: Aissaoui
authors.affiliation: Department of Cardiology, Dijon University Hospital, Dijon, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Cottin
authors.affiliation: Department of Cardiology, Grenoble University Hospital, Grenoble, France.
authors.forename: Gérald
authors.initials: G
authors.lastname: Vanzetto
authors.affiliation: Department of Cardiology, Toulouse University Hospital, Toulouse, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Carrié
authors.affiliation: Department of Cardiology, Saint-Etienne University Hospital, Saint-Etienne, France.
authors.forename: Karl
authors.initials: K
authors.lastname: Isaaz
authors.affiliation: Department of Cardiology, CH Saint-Louis, LaRochelle, France.
authors.forename: Yann
authors.initials: Y
authors.lastname: Valy
authors.affiliation: Department of Cardiology, Clinique Pasteur, Toulouse, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Tchetche
authors.affiliation: Department of Cardiology, University Hospital Jean Minjoz, Besançon, France.
authors.forename: François
authors.initials: F
authors.lastname: Schiele
authors.affiliation: Hôpital Bichat, Department of Cardiology, Assistance Publique des Hôpitaux de Paris, Paris, France; Université Paris-Diderot, Sorbonne Paris-Cité, Paris, France; INSERM U-698, Paris, France.
authors.forename: Philippe Gabriel
authors.initials: PG
authors.lastname: Steg
authors.affiliation: INSERM U-698, Paris, France; Clinical Research Unit (URC-EST), Hospital Saint Antoine, Assistance Publique des Hôpitaux de Paris, Paris, France; Université Pierre et Marie Curie, Paris, France.
authors.forename: Tabassome
authors.initials: T
authors.lastname: Simon
authors.affiliation: Departement of Cardiology, European Hospital of Georges Pompidou, Assistance Publique des Hôpitaux de Paris (AP-HP), University Paris Descartes, Paris, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Danchin
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000401:mortality / Q000628:therapy*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D057216:Propensity Score; D016016:Proportional Hazards Models; D012042:Registries; D013396:Suction / Q000379:methods; D015996:Survival Rate; D017131:Thrombectomy / Q000379:methods*; D061665:Time-to-Treatment; D016896:Treatment Outcome