title: Use and outcome of thrombus aspiration in patients with primary PCI for acute ST-elevation myocardial infarction: results from the multinational Euro Heart Survey PCI Registry.
abstract: The clinical benefit of thrombus aspiration (TA) in patients presenting with acute ST-elevation myocardial infarction (STEMI) and treated with primary percutaneous coronary intervention (PCI) is not well defined. Furthermore, there is a large variation in the use of TA in real-world registries. Between 2005 and 2008, a total of 7146 consecutive patients with acute STEMI undergoing primary PCI were prospectively enrolled into the PCI Registry of the Euro Heart Survey Programme. For the present analysis, patients treated additionally with TA (n = 897, 12.6 %) were compared with those without TA (n = 6249, 87.4 %). Patients with hemodynamic instability at initial presentation (15.1 vs. 11.0 %; p < 0.001) and resuscitation prior to PCI (10.4 vs. 7.4 %; p = 0.002) were more frequently treated with TA. TIMI flow grade 0/1 before PCI was more often found among those with TA (73.5 vs. 58.6 %; p < 0.001). After adjustment for confounding factors in the propensity score analysis, TA was not associated with improved in-hospital survival (risk difference -1.1 %, 95 % confidence interval -2.7 to 0.6 %). In this European real-world registry, the rate of TA use was low. Hemodynamically unstable patients were more likely to be treated with TA. Consistent with the results of the TASTE study and the TOTAL trial, TA was not associated with a significant reduction in short-term mortality.
authors.affiliation: Department of Cardiology, Justus-Liebig University of Giessen, Giessen, Germany.
authors.forename: Kay F
authors.initials: KF
authors.lastname: Weipert
authors.affiliation: Department of Cardiology, Justus-Liebig University of Giessen, Giessen, Germany. bauer-timm@gmx.de.
authors.forename: Timm
authors.initials: T
authors.lastname: Bauer
authors.affiliation: Department of Cardiology, Justus-Liebig University of Giessen, Giessen, Germany.
authors.forename: Holger M
authors.initials: HM
authors.lastname: Nef
authors.affiliation: Department of Cardiology, Kerckhoff Klinik, Bad Nauheim, Germany.
authors.forename: Helge
authors.initials: H
authors.lastname: Möllmann
authors.affiliation: Institut für Herzinfarktforschung, Ludwigshafen Am Rhein, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Hochadel
authors.affiliation: Cardio-Thoracic Center of Monaco, Monaco, Monaco.
authors.forename: Jean
authors.initials: J
authors.lastname: Marco
authors.affiliation: Rudolfstiftung Hospital, Vienna, Austria.
authors.forename: Franz
authors.initials: F
authors.lastname: Weidinger
authors.affiliation: Institut für Herzinfarktforschung, Ludwigshafen Am Rhein, Germany.|Department of Cardiology, Heart Center Ludwigshafen, Ludwigshafen Am Rhein, Germany.
authors.forename: Uwe
authors.initials: U
authors.lastname: Zeymer
authors.affiliation: Institut für Herzinfarktforschung, Ludwigshafen Am Rhein, Germany.|Department of Cardiology, Heart Center Ludwigshafen, Ludwigshafen Am Rhein, Germany.
authors.forename: Anselm K
authors.initials: AK
authors.lastname: Gitt
authors.affiliation: Department of Cardiology, Justus-Liebig University of Giessen, Giessen, Germany.|Department of Cardiology, Kerckhoff Klinik, Bad Nauheim, Germany.
authors.forename: Christian W
authors.initials: CW
authors.lastname: Hamm
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D003326:Coronary Circulation; D005060:Europe; D005260:Female; D006439:Hemodynamics; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000401:mortality; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D000072657:ST Elevation Myocardial Infarction / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D017131:Thrombectomy / Q000009:adverse effects / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome
keywords: Percutaneous coronary intervention; Real-world registry; ST-elevation myocardial infarction; Thrombus aspiration