Key result
Thrombus aspiration during primary percutaneous coronary intervention in STEMI patients with high thrombus burden did not significantly reduce major adverse cardiovascular events at 12 months compared to conventional PCI (7.4% vs 20.8%, OR 0.30, p=0.08).
Why the study?
Limited research exists on the effectiveness of thrombus aspiration during primary PCI for STEMI in Vietnam, underscoring the need for further studies.
Does manual thrombus aspiration improve myocardial perfusion and reduce major adverse cardiac events in STEMI patients with high thrombus burden undergoing primary PCI?
Observational (n=92)
No
Does manual thrombus aspiration improve myocardial perfusion and reduce major adverse cardiac events in STEMI patients with high thrombus burden undergoing primary PCI?
In STEMI patients with high thrombus burden, manual thrombus aspiration during primary PCI significantly improves myocardial perfusion and ST-segment resolution, though it does not significantly reduce 12-month MACE.
BACKGROUND: Primary percutaneous coronary intervention (PCI) can dislodge atherosclerotic debris, risking microvascular embolism. Thrombus aspiration (TA) before stenting in ST-segment elevation myocardial infarction (STEMI) patients has been linked to reduced mortality, lower recurrence of heart attacks, and improved cardiac function. However, limited research exists on the effectiveness of TA in Vietnam, underscoring the need for further studies to enhance cardiovascular care. This prospective observational study was conducted to evaluate the role of TA in STEMI patients admitted with a substantial thrombus burden at Nguyen Tri Phuong Hospital. RESULTS: Out of 92 participants, 68 underwent TA treatment. Post-treatment, the TA group exhibited better TIMI and TMP flow grades and a higher rate of ST-segment normalization, with no significant difference in major adverse cardiac events (MACEs) at 30-day and 12-month follow-ups compared to those untreated. CONCLUSIONS: TA during PCI enhances ST-segment normalization and TIMI and TMP scores in STEMI patients, improving myocardial perfusion. No difference in MACE occurrence was noted between groups after 30 days and 12 months, suggesting TA's potential benefits without increasing adverse outcomes.
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Le et al. (2024) conducted an observational in Acute ST-elevation myocardial infarction (STEMI) with high thrombus burden (n=92). Thrombus aspiration (TA) before stenting vs. Conventional PCI without TA was evaluated on Major adverse cardiac events (MACE) at 12 months (OR 0.30, 95% CI 0.08-1.19, p=0.08). Thrombus aspiration during primary percutaneous coronary intervention in STEMI patients with high thrombus burden did not significantly reduce major adverse cardiovascular events at 12 months compared to conventional PCI (7.4% vs 20.8%, OR 0.30, p=0.08).
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