Abstract 1784: Long-term Clinical Follow-up in ST Elevation Acute Myocardial Infarction (STEMI) Patients With Thrombus Aspiration Prior to Coronary Intervention, 2-year Results of The Vampire Study
Purpose: Long-term outcome of STEMI patients after primary PCI utilizing thrombectomy has never been investigated. Patients enrolled in the Vampire study (VAcuuM asPIration thrombus REmoval) were evaluated at 2 years.
Methods: The VAMPIRE study was a prospective randomized controlled trial at 23 institutions enrolling 355 patients with STEMI presenting within 24 hours of symptom onset. Patients were randomly assigned to primary PCI with or without thrombus aspiration using the TransVascular Aspiration Catheter (TVAC). Patients with cardiogenic shock, left main disease, and renal failure were not included in the study. Long-term data have been collected by clinic visits or telephone contacts.
Results: Long-term data of 269 patients were obtained (83.9% of eligible patients), so far. There was no difference in clinical and angiographic characteristics between the thrombus aspiration group (n=180) and the control group (n=175). Procedural success rates were 99% in the aspiration group and 98% in the control group. In-hospital MACE were 1.7% in both groups (p=NS). Blush grade-3 was achieved in 46% in the aspiration group, whereas 21% in the control group (p<0.001). Final TIMI-3 flow tended to be better in the aspiration group compared to the control group (87.3% vs 80.3%, p=0.08, respectively). MACE at 8 months was different between the 2 groups (7.6% vs 14.0%, p=0.045). At 2 years, differences in MACE were sustained (23.2% vs 35.8%, p=0.009), mainly because of lower TVR and non-TVR rates in the aspiration group. Cardiac death or MI rates were lower in the aspiration group (0.8% vs 3.7%, p=0.10).
Conclusions: Aspiration therapy prior to primary PCI may be beneficial in long-term prognosis of STEMI patients.