Comparing the Outcomes of Thrombus Aspiration Versus Standard Percutaneous Coronary Intervention in ST-Segment Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention

Background ST-segment elevation myocardial infarction (STEMI) is a major cause of cardiovascular mortality, mediated by coronary plaque rupture or erosion and acute thrombus formation. Early reperfusion is essential for reducing mortality and improving patient survival. Managing thrombus load during STEMI can be challenging and may require additional interventions beyond the conventional percutaneous coronary intervention (PCI) approach. This study aims to evaluate the impact of thrombus aspiration in STEMI patients undergoing primary PCI and its effect on procedural success and outcomes compared to standard PCI. Materials and methods This retrospective study was conducted at Sri Ramachandra Institute of Higher Education and Research (SRIHER), a university hospital in Chennai, India, by collecting baseline data from the medical records of 166 acute STEMI patients who underwent primary PCI. Patients were categorized into two groups based on whether they received thrombus aspiration or not. The primary outcomes studied were procedural success and in-hospital mortality, while secondary outcomes included safety, improvement in left ventricular function post-procedure, and the duration of hospital/ICU stay. The study was conducted in accordance with ethical guidelines and ensured patient confidentiality. Results A total of 166 patients were analyzed in this study, with chest pain being the major presenting symptom. Most patients had anterior wall myocardial infarction (AWMI) (75 (45.18%)), followed by inferior wall myocardial infarction (IWMI) (49 (29.52%)) and inferoposterior wall myocardial infarction (IPWMI) (29 (17.47%)). Most patients had a lesion in the left anterior descending artery (LAD), followed by the right coronary artery (RCA). The study found no significant difference in procedural success and outcomes between thrombus aspiration and conventional PCI, with both methods showing substantial improvements in ejection fraction on follow-up. Hospital and ICU stays were also not statistically different between the groups. Conclusion The study suggests that routine thrombus aspiration does not significantly improve myocardial recovery compared to conventional PCI, emphasizing the need for careful patient selection and optimal pharmacotherapy post-PCI.