title: Thrombus aspiration in non-ST-elevation myocardial infarction - 12-month clinical outcome of the randomised TATORT-NSTEMI trial.
abstract: BACKGROUND
  In the randomised TATORT-NSTEMI trial routine thrombus aspiration in comparison with standard percutaneous coronary intervention (PCI) did not reduce the primary endpoint of microvascular obstruction assessed by cardiac magnetic resonance imaging in patients with non-ST-elevation myocardial infarction (NSTEMI). So far, no data on long-term outcome of head-to-head comparisons between both treatment strategies in NSTEMI patients have been reported.
  
  
  METHODS
  The prospective, controlled, multicentre, randomised, open-label TATORT-NSTEMI trial assigned patients with NSTEMI and thrombus-containing lesions to aspiration thrombectomy plus PCI ( n=221) or standard PCI only ( n=219). The primary endpoint of the current analysis was the occurrence of major adverse cardiac events defined as the composite of death, myocardial reinfarction, target vessel revascularisation, and new congestive heart failure at 12-month follow-up. In addition, functional outcome and quality of life were assessed.
  
  
  RESULTS
  At one year, major adverse cardiac events occurred in 19 patients in the thrombectomy arm and 29 patients in the standard PCI group (8.7% vs. 13.4%, relative risk 0.63, 95% confidence interval 0.35-1.12, p=0.11). The individual components of the combined endpoint such as death ( p=0.20), myocardial reinfarction ( p=0.73), target vessel revascularisation ( p=0.42), and congestive heart failure ( p=0.18) were similar in both groups. Functional outcome and quality of life did not differ significantly between both groups (Canadian Cardiovascular Society class: p=0.68, New York Heart Association class: p=0.70 and EuroQol5D score: p=0.96). Post-hoc analyses revealed consistent results with regard to the occurrence of major adverse cardiac events across a wide range of subgroups (all p>0.05).
  
  
  CONCLUSIONS
  In this first randomised trial on thrombectomy in NSTEMI patients, routine thrombus aspiration before PCI did not improve clinical outcome at 12-month follow-up.
authors.affiliation: 1 Department of Cardiology, Angiology and Intensive Care Medicine, University Heart Centre Luebeck, University Hospital Schleswig-Holstein, Luebeck, Germany.|2 German Centre for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Luebeck, Luebeck, Germany.
authors.forename: Roza
authors.initials: R
authors.lastname: Meyer-Saraei
authors.affiliation: 1 Department of Cardiology, Angiology and Intensive Care Medicine, University Heart Centre Luebeck, University Hospital Schleswig-Holstein, Luebeck, Germany.|2 German Centre for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Luebeck, Luebeck, Germany.
authors.forename: Suzanne
authors.initials: S
authors.lastname: de Waha
authors.affiliation: 1 Department of Cardiology, Angiology and Intensive Care Medicine, University Heart Centre Luebeck, University Hospital Schleswig-Holstein, Luebeck, Germany.|2 German Centre for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Luebeck, Luebeck, Germany.
authors.forename: Ingo
authors.initials: I
authors.lastname: Eitel
authors.affiliation: 1 Department of Cardiology, Angiology and Intensive Care Medicine, University Heart Centre Luebeck, University Hospital Schleswig-Holstein, Luebeck, Germany.|2 German Centre for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Luebeck, Luebeck, Germany.
authors.forename: Steffen
authors.initials: S
authors.lastname: Desch
authors.affiliation: 3 Department of Internal Medicine III, University of Saarland, Homburg, Germany.
authors.forename: Bruno
authors.initials: B
authors.lastname: Scheller
authors.affiliation: 3 Department of Internal Medicine III, University of Saarland, Homburg, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Böhm
authors.affiliation: 4 Department of Cardiology, Zentralklinik Bad Berka, Germany.
authors.forename: Bernward
authors.initials: B
authors.lastname: Lauer
authors.affiliation: 5 Department of Cardiology/Cardiovascular Medicine, University of Tuebingen, Germany.
authors.forename: Meinrad
authors.initials: M
authors.lastname: Gawaz
authors.affiliation: 5 Department of Cardiology/Cardiovascular Medicine, University of Tuebingen, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Geisler
authors.affiliation: 6 Department of Internal Medicine II, Klinikum Frankfurt/Oder, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Gunkel
authors.affiliation: 7 Department of Internal Medicine, Unfallkrankenhaus Berlin, Germany.
authors.forename: Leonhard
authors.initials: L
authors.lastname: Bruch
authors.affiliation: 8 Department of Internal Medicine I, University of Leipzig, Germany.
authors.forename: Norbert
authors.initials: N
authors.lastname: Klein
authors.affiliation: 8 Department of Internal Medicine I, University of Leipzig, Germany.
authors.forename: Dietrich
authors.initials: D
authors.lastname: Pfeiffer
authors.affiliation: 9 Department of Internal Medicine/Cardiology, University of Leipzig Heart Centre, Germany.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Schuler
authors.affiliation: 10 Institut für Herzinfarktforschung, Klinikum der Stadt Ludwigshafen, Germany.
authors.forename: Uwe
authors.initials: U
authors.lastname: Zeymer
authors.affiliation: 1 Department of Cardiology, Angiology and Intensive Care Medicine, University Heart Centre Luebeck, University Hospital Schleswig-Holstein, Luebeck, Germany.|2 German Centre for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Luebeck, Luebeck, Germany.
authors.forename: Holger
authors.initials: H
authors.lastname: Thiele
mesh_terms: D002170:Canada; D003328:Coronary Thrombosis / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D000072658:Non-ST Elevated Myocardial Infarction / Q000150:complications*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D011788:Quality of Life; D017131:Thrombectomy / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome
keywords: Non-ST-elevation myocardial infarction; clinical outcome; no-reflow; thrombectomy