Background: The clinical efficacy and safety of adjunctive thrombus aspiration (TA) in patients with ST-segment elevation myocardial infarction (STEMI) during percutaneous coronary intervention (PCI) remain controversial.
Methods: Twenty five eligible randomized controlled trials were included to compare the use of thrombus aspiration (TA) with PCI and PCI-only for STEMI. The primary endpoint was all-cause mortality and death. The secondary endpoints were major adverse cardiac events (MACE), recurrent infarction (RI), target vessel revascularization (TVR), stent thrombosis (ST), perfusion surrogate markers and stroke.
Results: TIMI flow grade 3 and MBG 2-3 were significantly increased in the TA plus PCI arm compared with the PCI-only arm [relative risk (RR): 1.05, 95% confidence intervals (CI): 1.02-1.09, P = 0.004] and (RR: 1.68, 95% CI: 1.40-2.00, P < 0.001), respectively. There were no significant differences in all-cause mortality, MACEs, TVR and ST rates between the two groups. The RI rate was lower in the TA plus PCI arm than that in the PCI-only arm with short-term follow-up duration (RR: 0.60, 95% CI: 0.38-0.96, P = 0.03), but there was no significant difference in RI incidence over the medium- or long-term follow-up periods (RR: 1.00, 95% CI: 0.77-1.29, P = 0.98), and (RR: 0.96, 95% CI: 0.81-1.15, P = 0.69), respectively. There were statistically significant differences in the rates of crude stroke and stroke over the medium- or long-term follow-up periods and the crude stroke rate in the TA plus PCI (RR: 1.60, 95% CI: 1.08-2.38, P = 0.02) and (RR: 1.43, 95% CI: 1.03-1.98, P = 0.03), respectively; this was not observed between the two arms during the short-term follow-up period (RR: 1.47, 95% CI: 0.97-2.21, P = 0.07).
Conclusions: Routine TA-assisted PCI in STEMI patients can improve myocardial reperfusion and get limited benefits related to the clinical endpoints, which may be associated with stroke risk.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4921547 | PMC |
| http://dx.doi.org/10.11909/j.issn.1671-5411.2016.04.018 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Association between neutrophil to high-density lipoprotein ratio and no-reflow after coronary intervention: A cross-sectional study.
Medicine (Baltimore)
January 2025
Zhengzhou Central Hospital Affiliated to Zhengzhou University, Henan, China.
Inflammatory responses and lipid metabolism disorders are key components in the development of coronary artery disease and contribute to no-reflow after coronary intervention. This study aimed to investigate the association between the neutrophil to high-density lipoprotein ratio (NHR) and no-reflow phenomenon in ST-segment elevation myocardial infarction (STEMI) patients after primary percutaneous coronary intervention (PPCI). This study enrolled 288 patients with STEMI from September 1st, 2022 to February 29th, 2024, in the Zhengzhou Central Hospital Affiliated to Zhengzhou University.
View Article and Find Full Text PDFHeparin-induced thrombocytopenia requiring VA-ECMO management during percutaneous coronary intervention for acute coronary syndrome: A case report.
J Cardiol Cases
October 2024
Department of Cardiovascular Medicine, Okayama City Hospital, Okayama, Japan.
Unlabelled: Heparin-induced thrombocytopenia (HIT) is an immune-mediated disease with severe thromboembolic complications. HIT during percutaneous coronary intervention (PCI) can be fatal without prompt treatment. We report an unusual case of HIT observed during PCI for acute coronary syndrome (ACS).
View Article and Find Full Text PDFMechanisms of aortic dissection: From pathological changes to experimental and models.
Prog Mater Sci
April 2025
Institute of Biomechanics, Graz University of Technology, Austria.
Aortic dissection continues to be responsible for significant morbidity and mortality, although recent advances in medical data assimilation and in experimental and models have improved our understanding of the initiation and progression of the accumulation of blood within the aortic wall. Hence, there remains a pressing necessity for innovative and enhanced models to more accurately characterize the associated pathological changes. Early on, experimental models were employed to uncover mechanisms in aortic dissection, such as hemodynamic changes and alterations in wall microstructure, and to assess the efficacy of medical implants.
View Article and Find Full Text PDFPercutaneous Transcatheter Aspiration of a Large Left Atrial Mass.
JACC Case Rep
December 2024
Division of Cardiology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
An 85-year-old woman with atrial fibrillation was found to have a large 4.5- × 3.5-cm left atrial mass.
View Article and Find Full Text PDFTranscatheter mass extraction of left-sided cardiac masses has gained popularity in recent years, with scarce data on effectiveness, safety, and types of devices used. Mostly, left-sided aspirations use mechanical and continuous-flow-mediated devices (the AngioVac [AngioDynamics] and Penumbra systems [Penumbra]). To our knowledge, the use of manual aspiration devices has not been reported yet.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!