Clinical impact of thrombus aspiration during primary percutaneous coronary intervention: Results from Korea Acute Myocardial Infarction Registry

• Published in: Journal of cardiology 2012-05, Vol.59 (3), p.249-257
• Main Authors: Hachinohe, Daisuke, MD, Jeong, Myung Ho, MD, Saito, Shigeru, MD, Kim, Min Chol, MD, Cho, Kyung Hoon, MD, Ahmed, Khurshid, MD, Hwang, Seung Hwan, MD, Lee, Min Goo, MD, Sim, Doo Sun, MD, Park, Keun-Ho, MD, Kim, Ju Han, MD, Hong, Young Joon, MD, Ahn, Youngkeun, MD, Kang, Jung Chaee, MD, Kim, Jong Hyun, MD, Chae, Shung Chull, MD, Kim, Young Jo, MD, Hur, Seung Ho, MD, Seong, In Whan, MD, Hong, Taek Jong, MD, Choi, Donghoon, MD, Cho, Myeong Chan, MD, Kim, Chong Jin, MD, Seung, Ki Bae, MD, Chung, Wook Sung, MD, Jang, Yang Soo, MD, Rha, Seung Woon, MD, Bae, Jang Ho, MD, Park, Seung Jung, MD
• Format: Article
• Language: English
• Subjects: Aged; Cardiac Catheters; Cardiovascular; Endpoint Determination; Female; Humans; Korea - epidemiology; Male; Middle Aged; Myocardial Infarction - epidemiology; Myocardial Infarction - therapy; Percutaneous coronary intervention; Percutaneous Coronary Intervention - methods; Percutaneous Coronary Intervention - statistics & numerical data; Registries - statistics & numerical data; Retrospective Studies; ST-elevation myocardial infarction; Suction - methods; Thrombectomy - methods; Thrombectomy - statistics & numerical data; Thrombus aspiration; Time Factors; Treatment Outcome
• ISSN: 0914-5087; 1876-4738
• DOI: 10.1016/j.jjcc.2011.12.005

Summary Background The role of thrombus aspiration (TA) as an adjunct to primary percutaneous coronary intervention (PPCI) remains a matter of controversy. Methods and results A total of 2105 patients enrolled in the nationwide prospective Korea Acute Myocardial Infarction Registry, a cohort of 745 (35.4%) patients who underwent TA during PPCI was compared with 1360 (64.6%) patients who underwent conventional PCI without TA. Clinical outcomes at 12-months of overall enrolled patients and subgroups according to key variables were assessed using Cox regression models adjusted by propensity score. Although there was no significant difference among overall patients, in subgroup analyses, administration of glycoprotein (GP) IIb/IIIa inhibitor during PPCI [adjusted hazard ratio (HR) 0.329, 95% confidence interval (CI) 0.126–0.860, p = 0.023] and left anterior descending (LAD) as a culprit lesion (adjusted HR 0.516, 95% CI 0.275–0.971, p = 0.040) were the settings, in which TA was associated with a lower major adverse cardiac events (MACE) rate compared with non-TA. Conclusions Although TA does not improve clinical outcomes in overall patients who underwent PPCI, TA for LAD occlusion improves 12-month MACE. Furthermore, use of GP IIb/IIIa inhibitor with TA has a synergistic effect on clinical outcomes.