Clinical Efficacy of Thrombus Aspiration on 5‐Year Clinical Outcomes in Patients With ST‐Segment Elevation Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention
Authors: Watanabe Hiroki , Shiomi Hiroki , Nakatsuma Kenji , Morimoto Takeshi , Taniguchi Tomohiko , Furukawa Yutaka , Nakagawa Yoshihisa , Horie Minoru , Kimura Takeshi , Kimura Takeshi , Sakata Ryuzo , Marui Akira , Matsuda Mitsuo , Mitsuoka Hirokazu , Onoe Masahiko , Nakagawa Yoshihisa , Yamanaka Kazuo , Fujiwara Hisayoshi , Takatsu Yoshiki , Ohno Nobuhisa , Nohara Ryuji , Murakami Tomoyuki , Takeda Teruki , Nobuyoshi Masakiyo , Iwabuchi Masashi , Hanyu Michiya , Tatami Ryozo , Matsushita Tsutomu , Shirotani Manabu , Nishiwaki Noboru , Kita Toru , Furukawa Yutaka , Okada Yukikatsu , Kato Hiroshi , Eizawa Hiroshi , Is Katsuhisa , Tanaka Masaru , Nakayama Shogo , Lee Jong‐Dae , Nakano Akira , Koshiji Takaaki , Morioka Koichi , Takizawa Akinori , Shimamoto Mitsuomi , Yamazaki Fumio , Takahashi Masaaki , Nishizawa Junichiro , Horie Minoru , Takashima Hiroyuki , Tamura Takashi , Aota Masaki , Takahashi Mamoru , Tabata Takafumi , Tei Chuwa , Hamasaki Shuichi , Imoto Yutaka , Yamamoto Hiroyuki , Kambara Hirofumi , Doi Osamu , Matsuda Katsuhiko , Nara Masafumi , Mitsudo Kazuaki , Kadota Kazushige , Komiya Tatsuhiko , Miki Shinji , Mizoguchi Tetsu , Nakajima Hiroyuki , Ogawa Hisao , Sugiyama Seigo , Kawasuji Michio , Moriyama Syuji , Hattori Ryuichi , Aoyama Takeshi , Araki Makoto , Suwa Satoru , Tanbara Keiichi , Kitagawa Kumiko , Yamauchi Misato , Okamoto Naoko , Fujino Yumika , Tezuka Saori , Saeki Asuka , Hanazawa Miya , Sato Yuki , Hibi Chikako , Sasae Hitomi , Takinami Emi , Uchida Yuriko , Yamamoto Yuko , Nishida Satoko , Yoshimoto Mai , Maeda Sachiko , Miki Izumi , Minematsu Saeko , Abe Mitsuru , Shiomi Hiroki , Tada Tomohisa , Tazaki Junichi , Kato Yoshihiro , Hayano Mamoru , Tokushige Akihiro , Natsuaki Masahiro , Nakajima Tetsu 
Published: June 2015

Background

Adjunctive thrombus aspiration (
TA
) during primary percutaneous coronary intervention (
PCI
) was reported to promote better coronary and myocardial reperfusion. However, long‐term mortality benefit of
TA
remains controversial. The objective of this study is to investigate the clinical impact of
TA
on long‐term clinical outcomes in patients with
ST
‐segment elevation myocardial infarction (STEMI) undergoing primary
PCI
.

Methods and Results

The
CREDO
‐Kyoto
AMI
Registry is a large‐scale cohort study of acute myocardial infarction patients undergoing coronary revascularization in 2005–2007 at 26 hospitals in Japan. Among 5429 patients enrolled in the registry, the current study population consisted of 3536 patients who arrived at the hospital within 12 hours after the symptom onset and underwent primary
PCI
. Clinical outcomes were compared between the 2 patient groups with or without
TA
. During primary
PCI
procedures, 2239 out of 3536 (63%) patients underwent
TA
(
TA
group). The cumulative 5‐year incidence of all‐cause death was significantly lower in the
TA
group than in the non‐
TA
group (18.5% versus 23.9%, log‐rank
P
<0.001). After adjusting for confounders, however, the risk for all‐cause death in the
TA
group was not significantly lower than that in the non‐
TA
group (hazard ratio: 0.90, 95%
CI
: 0.76 to 1.06,
P
=0.21). The adjusted risks for cardiac death, myocardial infarction, stroke, and target‐lesion revascularization were also not significantly different between the 2 groups.

Conclusions

Adjunctive
TA
during primary
PCI
was not associated with better 5‐year mortality in STEMI patients.