Affiliation:
1. Department of Cardiology, Faculty of Health, Örebro University, Sweden
2. Department of Medical Sciences, Cardiology and Uppsala Clinical Research Center, Uppsala University, Sweden
Abstract
Background
The clinical effect of thrombus aspiration in
ST
‐elevation myocardial infarction may depend on the type of aspiration catheter and stenting technique.
Methods and Results
The multicenter, prospective, randomized, open‐label trial Thrombus Aspiration in
ST
‐Elevation myocardial infarction in Scandinavia (
TASTE
) did not demonstrate a clinical benefit of thrombus aspiration compared to percutaneous coronary intervention alone. We assessed the effect of type of aspiration device, stent type, direct stenting, and postdilatation on outcomes at 1 year. There was no difference in all‐cause mortality, between the 3 most frequently used aspiration catheters (Eliminate [Terumo] 5.4%, Export [Medtronic] 5.0%, Pronto [Vascular Solutions] 4.5%) in patients randomized to thrombus aspiration. There was no difference in mortality between directly stented patients randomized to thrombus aspiration compared to patients randomized to percutaneous coronary intervention only (risk ratio 1.08, 95%
CI
0.70 to 1.67,
P
=0.73). Similarly, there was no difference in mortality between the 2 randomized groups for patients receiving drug‐eluting stents (risk ratio 0.89, 95%
CI
0.63 to 1.26,
P
=0.50) or for those treated with postdilation (risk ratio 0.72, 95%
CI
0.49 to 1.07,
P
=0.11). Furthermore, there was no difference in rehospitalization for myocardial infarction or stent thrombosis between the randomized arms in any of the subgroups.
Conclusions
In patients with
ST
‐elevation myocardial infarction randomized to thrombus aspiration, the type of aspiration catheter did not affect outcome. Stent type, direct stenting, or postdilation did not affect outcome irrespective of treatment with thrombus aspiration and percutaneous coronary intervention or percutaneous coronary intervention alone.
Clinical Trial Registration
URL
: ClinicalTrials.gov. Unique identifier:
NCT
01093404,
https://clinicaltrials.gov/ct2/show/NCT01093404
.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Cardiology and Cardiovascular Medicine
Cited by
19 articles.
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