title: Thrombus aspiration in patients with large anterior myocardial infarction: A Thrombus Aspiration in ST-Elevation myocardial infarction in Scandinavia trial substudy.
abstract: BACKGROUND
  The TASTE trial did not demonstrate clinical benefit of thrombus aspiration (TA). High-risk patients might benefit from TA.
  
  
  METHODS
  The TASTE trial was a multicenter, randomized, controlled, open-label trial obtaining end points from national registries. Patients (n = 7,244) with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI) were randomly assigned 1:1 to TA and PCI or to PCI alone. We assessed the 1-year clinical effect of TA in a subgroup with potentially large anterior STEMI: mid or proximal left anterior descending coronary artery infarct lesion, thrombolysis in myocardial infarction 0 to 2 flow, and symptom onset to PCI time ≤5 hours. In this substudy, patient eligibility criteria corresponded to that of the INFUSE-AMI study.
  
  
  RESULTS
  In total, 1,826 patients fulfilled inclusion criteria. All-cause mortality at 1 year of patients randomized to TA did not differ from those randomized to PCI only (hazard ratio [HR] 1.05, 95% CI 0.74-1.49, P = .77). Rates of rehospitalization for myocardial infarction, heart failure, and stent thrombosis did not differ between groups (HR 0.87, 95% CI 0.51-1.46, P = .59; HR 1.10 95% CI 0.77-1.58, P = .58; and HR 0.75, 95% CI 0.30-1.86, P = .53, respectively). This was also the case for the combined end point of all-cause mortality and rehospitalization for myocardial infarction, heart failure, or stent thrombosis (HR 1.00, 95% CI 0.79-1.26, P = .99).
  
  
  CONCLUSIONS
  In patients with STEMI and large area of myocardium at risk, TA did not affect outcome within 1 year.
authors: Department of Cardiology, Faculty of Health, Örebro University, Örebro, Sweden. Electronic address: fredrik.calais@regionorebrolan.se.
authors: Fredrik
authors: F
authors: Calais
authors: Department of Medical Sciences, Cardiology, and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden.
authors: Bo
authors: B
authors: Lagerqvist
authors: Centre for Clinical Research, Uppsala University, Central Hospital, Västerås, Sweden.
authors: Jerzy
authors: J
authors: Leppert
authors: Department of Medical Sciences, Cardiology, and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden.
authors: Stefan K
authors: SK
authors: James
authors: Department of Cardiology, Faculty of Health, Örebro University, Örebro, Sweden.
authors: Ole
authors: O
authors: Fröbert
mesh_terms: D000368:Aged; D056988:Anterior Wall Myocardial Infarction / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000150:complications / Q000401:mortality / Q000628:therapy*; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D011446:Prospective Studies; D012042:Registries; D013396:Suction / Q000379:methods*; D015996:Survival Rate / Q000639:trends; D013548:Sweden / Q000453:epidemiology; D017131:Thrombectomy / Q000379:methods*; D016896:Treatment Outcome