Key result
Thrombus aspiration did not show significant advantages over routine percutaneous coronary intervention in reducing MACE in the general STEMI population, but proved effective in specific subgroups including patients with hyperglycemia, high D-dimer levels, and elderly or frail patients.
Why the study?
Thrombus aspiration has not reduced MACEs compared with routine PCI in unselected STEMI patients, but remains in use for massive thrombosis, prompting a review of subgroups with favorable outcomes.
Does thrombus aspiration reduce major adverse cardiovascular events compared to routine PCI in patients with STEMI?
Does thrombus aspiration reduce major adverse cardiovascular events compared to routine PCI in patients with STEMI?
While routine thrombus aspiration is not beneficial for the general STEMI population, it may offer advantages in specific high-risk subgroups such as those with hyperglycemia, elevated D-dimer, or frailty.
Does not support routine thrombus aspiration in STEMI; leaves open targeted benefit in high-risk subgroups for prospective trials.
Thrombus aspiration has not shown significant advantages over routine percutaneous coronary intervention in reducing the incidence of major adverse cardiovascular events (MACEs) in the general heterogeneous population of patients with ST-segment elevation myocardial infarction (STEMI). However, it is still practically used in cases of massive coronary artery thrombosis. This review presents the results of studies on thrombus aspiration in patients with STEMI with a focus on favorable outcomes. According to the literature data, thrombus aspiration proved to be effective in following groups of STEMI patients: 1) patients with hyperglycemia; 2) patients with high D-dimer levels; 3) elderly and frail patients. In order to assess the effectiveness of reperfusion, only angiographic characteristics are still used in routine practice, while multimodal imaging methods have not yet become widespread. Moreover, optimal and unified thrombus aspiration protocols have not yet been developed.
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Ryabov et al. (2023) conducted a review in ST-segment elevation myocardial infarction (STEMI). Thrombus aspiration vs. Routine percutaneous coronary intervention (PCI alone) was evaluated on Major adverse cardiovascular events (MACEs). Thrombus aspiration did not show significant advantages over routine percutaneous coronary intervention in reducing MACE in the general STEMI population, but proved effective in specific subgroups including patients with hyperglycemia, high D-dimer levels, and elderly or frail patients.
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