No beneficial effects of coronary thrombectomy on left ventricular systolic and diastolic function in patients with acute S-T elevation myocardial infarction: a randomized clinical trial.

Objective: We sought to evaluate the effect of acute coronary thrombectomy, as adjunctive treatment to primary percutaneous coronary intervention, on the systolic and diastolic left ventricular function, in patients with acute S-T elevation myocardial infarction.

Methods: In a prospective randomized study, patients with acute S-T elevation myocardial infarction were randomized to treatment with primary percutaneous coronary intervention with or without thrombectomy. Outcome measures were left ventricular volumes and ejection fraction in addition to systolic long-axis function, estimated from the tissue Doppler systolic velocities of the mitral ring. Diastolic function was assessed by mitral inflow and diastolic velocities of the mitral ring movement.

Results: Of the 215 patients included, 172 patients (80%) had a 30-day follow-up. There were no significant differences in ejection fraction between groups during follow-up (thrombectomy at baseline 47 +/- 14% vs 47 +/- 14% at follow-up, control group at baseline 48 +/- 11% vs 51 +/- 12% at follow-up, P = not significant). Systolic velocities were significantly higher in the control group at follow-up (thrombectomy, at baseline, 6.5 +/- 1.9 vs 6.3 +/- 1.8 cm/s at follow-up; control group, at baseline, 6.5 +/- 1.9 vs 7.0 +/- 1.9 cm/s at follow-up; P < .05). There were no significant differences in diastolic function between the two groups.

Conclusion: Thrombectomy had no beneficial effect on the left ventricular function in patients with acute S-T elevation myocardial infarction.