Efficacy and safety of thrombus aspiration in ST-segment elevation myocardial infarction: an updated systematic review and meta-analysis of randomised clinical trials

European Heart Journal. Acute Cardiovascular Care
Nevio TaglieriClaudio Rapezzi

Abstract

The role of thrombus aspiration plus primary percutaneous coronary intervention in ST-segment elevation myocardial infarction remains controversial. We performed a meta-analysis of 25 randomised controlled trials in which 21,740 ST-segment elevation myocardial infarction patients were randomly assigned to thrombus aspiration plus primary percutaneous coronary intervention or primary percutaneous coronary intervention. Study endpoints were: death, myocardial infarction, stent thrombosis and stroke. On pooled analysis, the risk of death (4.3% vs. 4.8%, odds ratio (OR) 0.90, 95% confidence interval (CI) 0.79-1.03; P=0.123), myocardial infarction (2.4% vs. 2.5%, OR 0.95, 95% CI 0.80-1.13; P=0.57) and stent thrombosis (1.3% vs. 1.6%, OR 0.80, 95% CI 0.63-1.01; P=0.066) was similar between thrombus aspiration plus primary percutaneous coronary intervention and primary percutaneous coronary intervention. The risk of stroke was higher in the thrombus aspiration plus primary percutaneous coronary intervention than the primary percutaneous coronary intervention group (0.84% vs. 0.59%, OR 1.401, 95% CI 1.004-1.954; P=0.047). However, on sensitivity analysis after removing the TOTAL trial, thrombus aspiration plus primary percutaneous coro...Continue Reading

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Citations

Feb 12, 2019·European Heart Journal. Acute Cardiovascular Care
Apr 6, 2021·Aging Clinical and Experimental Research·Pasquale MoneGaetano Santulli
Nov 16, 2021·Journal of the American Heart Association·Yohei SotomiUNKNOWN Osaka Acute Coronary Insufficiency Study (OACIS) Group

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Methods Mentioned

BETA
coronary artery bypass

Software Mentioned

TAPAS
TOTAL
SE
Stata
TASTE

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