Long-term outcome after thrombus aspiration in non-ST-elevation myocardial infarction: results from the TATORT-NSTEMI trial: Thrombus aspiration in acute myocardial infarction

• Published in: Clinical research in cardiology 2020-10, Vol.109 (10), p.1223-1231
• Main Authors: Feistritzer, Hans-Josef, Meyer-Saraei, Roza, Lober, Christiane, Böhm, Michael, Scheller, Bruno, Lauer, Bernward, Geisler, Tobias, Gawaz, Meinrad, Bruch, Leonhard, Klein, Norbert, Zeymer, Uwe, Eitel, Ingo, Jobs, Alexander, Freund, Anne, Desch, Steffen, de Waha-Thiele, Suzanne, Thiele, Holger
• Format: Article
• Language: English
• Subjects: Cardiology; Medicine; Medicine & Public Health; Original Paper
• ISSN: 1861-0684; 1861-0692
• DOI: 10.1007/s00392-020-01613-0

Aims To investigate the long-term prognostic value of aspiration thrombectomy in conjunction with primary percutaneous coronary intervention (PCI) compared to conventional PCI in patients with non-ST-elevation myocardial infarction (NSTEMI). Methods In the randomized TATORT-NSTEMI (Thrombus aspiration in thrombus containing culprit lesions in non-ST-elevation myocardial infarction) trial, NSTEMI patients with thrombus containing culprit lesions were randomized to either PCI with aspiration thrombectomy or conventional PCI. The endpoint was a combination of all-cause death, reinfarction and new congestive heart failure. Results From 440 patients initially randomized, outcome data were available in 432 (98.2%) patients at a median follow-up of 4.9 (interquartile range [IQR] 4.4–5.0) years. Thrombectomy was associated with a significant reduction of the combined endpoint compared to conventional PCI (19.9% vs. 30.7%, p  = 0.01). This finding was primarily driven by a reduced rate of reinfarction with thrombectomy (3.4% vs. 10.3%, p  = 0.01). Thrombectomy was still independently associated with the combined endpoint after multivariable adjustment (hazard ratio [HR] 0.47, 95% confidence interval [CI] 0.30–0.76, p  = 0.002). Findings were consistent across all analyzed subgroups ( p values for interaction all > 0.05). Conclusions In NSTEMI, thrombus aspiration is associated with favorable clinical outcome during long-term follow-up. Clinical trial registration NCT01612312.