Impact of thrombus aspiration during ST-Elevation Myocardial Infarction: a six month composite endpoint and risk of stroke analyses of the TASTE trialReportar como inadecuado




Impact of thrombus aspiration during ST-Elevation Myocardial Infarction: a six month composite endpoint and risk of stroke analyses of the TASTE trial - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

BMC Cardiovascular Disorders

, 16:62

Coronary artery disease

Abstract

BackgroundRoutine thrombus aspiration during primary percutaneous coronary intervention PCI in ST-elevation myocardial infarction STEMI did not reduce the primary composite endpoint in the -A Randomised Trial of Routine Aspiration ThrOmbecTomy With PCI Versus PCI ALone in Patients With STEMI Undergoing Primary PCI- TOTAL trial. We aimed to analyse a similar endpoint in -The Thrombus Aspiration in ST-Elevation myocardial infarction in Scandinavia- TASTE trial up to 180 days.

MethodsIn TASTE, 7244 patients with STEMI were randomised to thrombus aspiration followed by PCI or to PCI alone. We analysed the quadruple composite endpoint of cardiovascular death, cardiogenic shock, rehospitalisation for myocardial infarction, or new hospitalisation for heart failure. Furthermore, an extended net-benefit composite endpoint including stent thrombosis, target vessel revascularization or stroke within 180 days was analysed.

ResultsThe primary quadruple composite endpoint occurred in 8.7 % 316 of 3621 in the thrombus aspiration group compared to 9.3 % 338 of 3623 in the PCI alone group hazard ratio HR, 0.93; 95 % confidence interval CI; 0.80 - 1.09, P = 0.36 and the extended net-benefit composite endpoint in 12.0 % 436 vs. 13.2 % 479 HR, 0.90; 95 % CI; 0.79 - 1.03, P = 0.12. Stroke within 30 days occurred in 0.7 % 27 vs. 0.7 % 24 HR, 0.89; 95 % CI; 0.51–1.54, P = 0.68.

ConclusionsA large and an extended composite endpoint analysis from the TASTE trial did not demonstrate any clinical benefit of routine thrombus aspiration during PCI in patients with STEMI. There was no evidence of an increased risk of stroke with thrombus aspiration.

KeywordsMyocardial infarction STEMI PCI Thrombus aspiration AbbreviationsCVcardiovascular

HHheart failure

HRhazard ratio

ICDInternational classification of disease

MImyocardial infarction

NPRThe National Patient Registry

NYHANew York Heart Association

PCIpercutaneous coronary intervention

RCTrandomized clinical trial

R-RCTregistry based randomised clinical trial

SCAARSwedish angiography and angioplasty registry

STstent thrombosis

STEMIST-elevation myocardial infarction

SWEDEHEARTSwedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies registry

TASTEThe Thrombus Aspiration in ST-Elevation myocardial infarction in Scandinavia trial

TOTALA Randomised Trial of Routine Aspiration ThrOmbecTomy With PCI Versus PCI ALone in Patients With STEMI Undergoing Primary PCI

TVRtarget vessel revascularization

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Autor: Göran K Olivecrona - Bo Lagerqvist - Ole Fröbert - Thórarinn Gudnason - Michael Maeng - Truls Råmunddal - Jan Haupt -

Fuente: https://link.springer.com/



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