title: ST-elevation myocardial infarction, thrombus aspiration, and different invasive strategies. A TASTE trial substudy.
abstract: BACKGROUND
  The clinical effect of thrombus aspiration in ST-elevation myocardial infarction may depend on the type of aspiration catheter and stenting technique.
  
  
  RESULTS
  The multicenter, prospective, randomized, open-label trial Thrombus Aspiration in ST-Elevation myocardial infarction in Scandinavia (TASTE) did not demonstrate a clinical benefit of thrombus aspiration compared to percutaneous coronary intervention alone. We assessed the effect of type of aspiration device, stent type, direct stenting, and postdilatation on outcomes at 1 year. There was no difference in all-cause mortality, between the 3 most frequently used aspiration catheters (Eliminate [Terumo] 5.4%, Export [Medtronic] 5.0%, Pronto [Vascular Solutions] 4.5%) in patients randomized to thrombus aspiration. There was no difference in mortality between directly stented patients randomized to thrombus aspiration compared to patients randomized to percutaneous coronary intervention only (risk ratio 1.08, 95% CI 0.70 to 1.67, P=0.73). Similarly, there was no difference in mortality between the 2 randomized groups for patients receiving drug-eluting stents (risk ratio 0.89, 95% CI 0.63 to 1.26, P=0.50) or for those treated with postdilation (risk ratio 0.72, 95% CI 0.49 to 1.07, P=0.11). Furthermore, there was no difference in rehospitalization for myocardial infarction or stent thrombosis between the randomized arms in any of the subgroups.
  
  
  CONCLUSIONS
  In patients with ST-elevation myocardial infarction randomized to thrombus aspiration, the type of aspiration catheter did not affect outcome. Stent type, direct stenting, or postdilation did not affect outcome irrespective of treatment with thrombus aspiration and percutaneous coronary intervention or percutaneous coronary intervention alone.
  
  
  BACKGROUND
  URL: ClinicalTrials.gov. Unique identifier: NCT01093404, https://clinicaltrials.gov/ct2/show/NCT01093404.
authors.affiliation: Department of Cardiology, Faculty of Health, Örebro University, Sweden (O.F., F.C.).
authors.forename: Ole
authors.initials: O
authors.lastname: Fröbert
authors.affiliation: Department of Cardiology, Faculty of Health, Örebro University, Sweden (O.F., F.C.).
authors.forename: Fredrik
authors.initials: F
authors.lastname: Calais
authors.affiliation: Department of Medical Sciences, Cardiology and Uppsala Clinical Research Center, Uppsala University, Sweden (S.K.J., B.L.).
authors.forename: Stefan K
authors.initials: SK
authors.lastname: James
authors.affiliation: Department of Medical Sciences, Cardiology and Uppsala Clinical Research Center, Uppsala University, Sweden (S.K.J., B.L.).
authors.forename: Bo
authors.initials: B
authors.lastname: Lagerqvist
mesh_terms: D000368:Aged; D062906:Cardiac Catheters; D003328:Coronary Thrombosis / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000601:surgery*; D062645:Percutaneous Coronary Intervention / Q000379:methods; D015607:Stents; D017131:Thrombectomy / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome
keywords: angioplasty; myocardial infarction; stenting; thrombus aspiration