eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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1/2016
vol. 12
 
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abstract:
Original paper

No clinical benefit from manual thrombus aspiration in patients with non-ST-elevation myocardial infarction

Zbigniew Siudak
,
Artur Dziewierz
,
Tomasz Rakowski
,
Tomasz Tokarek
,
Waldemar Mielecki
,
Anna Żabówka
,
Krzysztof Plens
,
Dariusz Dudek

Adv Interv Cardiol 2016; 12, 1 (43): 32–40
DOI: https://doi.org/10.5114/pwki.2016.56947
Online publish date: 2016/02/11
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Introduction: There are scarce data on the usefulness of manual thrombectomy among patients with non-ST-elevation myocardial infarction (NSTEMI). Early positive reports were not supported by the clinical outcome in the recent TATORT-NSTEMI (Thrombus Aspiration in Thrombus Containing Culprit Lesions in Non-ST-Elevation Myocardial Infarction) study.

Aim: To analyze the long-term outcome of NSTEMI patients treated with manual thrombectomy during percutaneous coronary intervention (PCI) in the Polish multicenter National Registry of Drug Eluting Stents (NRDES) study.

Material and methods: There were 13 catheterization laboratories in Poland that enrolled patients in NRDES Registry in 2010–2011. Patients with a diagnosis of NSTEMI were divided into two groups: those that were treated with manual thrombectomy for their primary PCI (T) and those who were not (NT).

Results: There were 923 patients diagnosed with NSTEMI in NRDES. Aspiration thrombectomy was used in 71 (7.7%) patients and the remaining 852 (92.3%) NSTEMI cases were treated without thrombectomy during the index PCI. Thrombectomy was more often used in patients with TIMI less than 1, thrombus grades 4 and 5 and older male patients. Percutaneous coronary interventions complications such as distal embolization and slow flow were more often observed in the thrombectomy subgroup. Overall mortality at 1 year was 1.69% in the T and 5.92% in the NT group (p = 0.24 and p = 0.32 after propensity score matching adjustment with p = 0.11 in the multivariate logistic regression model).

Conclusions: There was no mortality benefit from thrombus aspiration in NSTEMI patients at 1-year follow-up.
keywords:

myocardial infarction, registry, thrombectomy
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