Abstract 4688: Three-year Clinical Follow-up of the Vampire Study in St Elevation Acute Myocardial Infarction (STEMI) Patients With Thrombus Aspiration Prior to Coronary Intervention
Purpose: Long-term outcome of STEMI patients after primary PCI utilizing thrombectomy is still unknown. Patients enrolled in the Vampire study (VAcuuM asPIration thrombus REmoval) were evaluated at 3-year follow-up.
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. MACE was defined as death, MI, or any revascularization.
Results: 3-year data of 287 patients were obtained (88% of eligible patients). There was no difference in clinical and angiographic characteristics between the thrombus aspiration group (n=180) and the control group (n=175). In-hospital MACE were 1.7% in both groups (p=NS). 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). Differences in MACE were increased at 3 years, (20.0% vs 35.2%, p=0.003), mainly because of lower TVR and non-TVR rates in the aspiration group. Cardiac death or MI occurred only in 1 patient after discharge in the aspiration group, whereas 4 patients in the control group.
Conclusions: Aspiration therapy prior to primary PCI may be beneficial in the long-term prognosis of STEMI patients.