title: No clinical benefit from manual thrombus aspiration in patients with non-ST-elevation myocardial infarction.
abstract: BACKGROUND
  There are scarce data on the usefulness of manual thrombectomy among patients with non-ST-elevation myocardial infarction (NSTEMI). Early positive reports were not supported by the clinical outcome in the recent TATORT-NSTEMI (Thrombus Aspiration in Thrombus Containing Culprit Lesions in Non-ST-Elevation Myocardial Infarction) study.
  
  
  OBJECTIVE
  To analyze the long-term outcome of NSTEMI patients treated with manual thrombectomy during percutaneous coronary intervention (PCI) in the Polish multicenter National Registry of Drug Eluting Stents (NRDES) study.
  
  
  METHODS
  There were 13 catheterization laboratories in Poland that enrolled patients in NRDES Registry in 2010-2011. Patients with a diagnosis of NSTEMI were divided into two groups: those that were treated with manual thrombectomy for their primary PCI (T) and those who were not (NT).
  
  
  RESULTS
  There were 923 patients diagnosed with NSTEMI in NRDES. Aspiration thrombectomy was used in 71 (7.7%) patients and the remaining 852 (92.3%) NSTEMI cases were treated without thrombectomy during the index PCI. Thrombectomy was more often used in patients with TIMI less than 1, thrombus grades 4 and 5 and older male patients. Percutaneous coronary interventions complications such as distal embolization and slow flow were more often observed in the thrombectomy subgroup. Overall mortality at 1 year was 1.69% in the T and 5.92% in the NT group (p = 0.24 and p = 0.32 after propensity score matching adjustment with p = 0.11 in the multivariate logistic regression model).
  
  
  CONCLUSIONS
  There was no mortality benefit from thrombus aspiration in NSTEMI patients at 1-year follow-up.
authors.affiliation: Department of Interventional Cardiology, University Hospital, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Siudak
authors.affiliation: Department of Interventional Cardiology, University Hospital, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Artur
authors.initials: A
authors.lastname: Dziewierz
authors.affiliation: Department of Interventional Cardiology, University Hospital, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Rakowski
authors.affiliation: Department of Interventional Cardiology, University Hospital, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Tokarek
authors.affiliation: Department of Interventional Cardiology, University Hospital, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Waldemar
authors.initials: W
authors.lastname: Mielecki
authors.affiliation: Department of Interventional Cardiology, University Hospital, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Żabówka
authors.affiliation: Krakow Cardiovascular Research Institute, Krakow, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Plens
authors.affiliation: Department of Interventional Cardiology, University Hospital, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Dariusz
authors.initials: D
authors.lastname: Dudek
keywords: myocardial infarction; registry; thrombectomy