Long-term outcome similar with thrombus aspiration and stents in STEMI


New research confirms thrombus aspiration during percutaneous coronary intervention in patients with acute ST-segment elevation myocardial infarction (STEMI) provides long-term outcomes similar to conventional intervention with bare metal or drug-eluting stents.

Findings published in a special STEMI-focused issue of Catheterization and Cardiovascular Interventions, a journal of the Society for Cardiovascular Angiography and Interventions (SCAI), report that compared to conventional percutaneous coronary intervention, thrombectomy does not affect rates of major adverse cardiac events at two-year follow-up.

For the current study, Maarten Vink and colleagues in The Netherlands analysed data from the PASSION trial to evaluate long-term outcomes with thrombus aspiration versus standard percutaneous coronary intervention with stents. As part of the trial 619 STEMI patients were randomised to paclitaxel-eluting or bare metal stents, with thrombus aspiration performed in just over half of participants (311). Long-term outcomes that included cardiac death, recurrent myocardial infarction, or target lesion revascularisation were compared between patients undergoing thrombus aspiration compared to conventional percutaneous coronary intervention.

Two-year follow-up was completed for 598 patients. Cumulative incidence of cardiac death, recurrent myocardial infarction, and target lesion revascularisation was found in 13% of thrombus aspiration patients and 13.5% of participants in the conventional percutaneous coronary intervention group. Target lesion revascularisation incidence was comparable in the thrombus aspiration and standard percutaneous coronary intervention groups at 7.7% and 8.3%, respectively. Researchers did not observe a significant difference in adverse cardiac events between the groups.

“Our post-hoc analysis of the PASSION trial found that thrombus aspiration in conjunction with percutaneous coronary intervention did not affect the incidence of adverse cardiac events at the two-year follow-up compared to conventional percutaneous coronary intervention,” concluded Vink. “We observed no difference in stent thrombosis between the two groups.”