Abstract 15185: Does Thrombus Aspiration Improve Clinical Outcome Post Primary PCI? Insights from the Melbourne Interventional Group (MIG) Registry
Background: Randomized controlled trials have shown an improvement in surrogate endpoints with aspiration thrombectomy (TA) compared to standard PCI. However, a benefit in clinical outcomes has yet to be demonstrated. Despite this, NHF gives TA class IA recommendation. TA can be difficult and often at the expense of longer restoration of perfusion time. As such, there remains clinical equipoise as to the value of TA in primary PCI. Aim: To determine if there is a difference in procedural features and clinical outcomes in those patients treated with TA in Primary PCI in a large registry.
Methods: We prospectively collected data from 2833 patients from the MIG registry in Australia who presented with STEMI (<24hr) between July 2006 and November 2012. Multivariate analysis was performed to determine predictors of 12-month major adverse cardiac events (MACE).
Results: There were more males, smokers, and hypertensive patients in the TA group. Thrombectomy aspiration was more likely to be used with TIMI 0 flow. The lesions were more complex (B2/C), and longer with more “no-reflow”. There was less DES usage in the TA group. TIMI flow post procedure was not significantly different between the groups. No difference was seen in 30-day mortality.
Conclusion: The use of TA in Primary PCI did not improve in-hospital mortality or one year MACE outcomes.
- © 2012 by American Heart Association, Inc.