Thrombus aspiration in patients with ST-elevation myocardial infarction

• Main Author: Pereira, Hélder
• Publication Date: 2018
• Other Authors: Caldeira, Daniel, Teles, Rui Campante, Costa, Marco, da Silva, Pedro Canas, da Gama Ribeiro, Vasco, Brandão, Vítor, Martins, Dinis, Matias, Fernando, Pereira-Machado, Francisco, Baptista, José, Abreu, Pedro Farto e., Santos, Ricardo, Drummond, António, de Carvalho, Henrique Cyrne, Calisto, João, Silva, João Carlos, Pipa, João Luís, Marques, Jorge, Sousa, Paulino, Fernandes, Renato, Ferreira, Rui Cruz, Ramos, Sousa, Oliveira, Eduardo Infante, de Sousa Almeida, Manuel
• Format: Article
• Language: eng
• Source: Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
• Download full: https://doi.org/10.1186/s12872-018-0794-4
• topic: Angioplasty; Mortality; Portugal; Primary PCI; Thrombectomy; Thrombus aspiration; Cardiology and Cardiovascular Medicine

Background: We aimed to evaluate the impact of thrombus aspiration (TA) during primary percutaneous coronary intervention (P-PCI) in 'real-world' settings. Methods: We performed a retrospective study, using data from the National Registry of Interventional Cardiology (RNCI 2006-2012, Portugal) with ST-elevation myocardial infarction (STEMI) patients treated with P-PCI. The primary outcome, in-hospital mortality, was analysed through adjusted odds ratio (aOR) and 95% confidence intervals (95%CI). Results: We assessed data for 9458 STEMI patients that undergone P-PCI (35% treated with TA). The risk of in-hospital mortality with TA (aOR 0.93, 95%CI:0.54-1.60) was not significantly decreased. After matching patients through the propensity score, TA reduced significantly the risk of in-hospital mortality (OR 0.58, 95%CI:0.35-0.98; 3500 patients). Conclusions: The whole cohort data does not support the routine use of TA in P-PCI, but the results of the propensity-score matched cohort suggests that the use of selective TA may improve the short-term risks of STEMI.