Coronary disease & ACSCohort study
Failed Thrombus Aspiration and Reduced Myocardial Perfusion in Patients With STEMI and Large Thrombus Burden
- Prospective registry cohort study
- consecutive patients
- matched comparison
Authors' conclusion
TA failure is associated with reduced myocardial perfusion in patients with STEMI and LTB.
Study context
- Population
- Patients with STEMI and large thrombus burden (thrombus grade ≥3) undergoing manual thrombus aspiration (TA) during primary PCI
- Participants
- 812 patients
- Exposure
- Failed TA vs successful TA
- Failed TAn = 279 [34.4%]
- Successful TAn = 533 [65.6%]reference
- Outcome
- Final TIMI flow grade 3 (myocardial perfusion)
Main finding
As reported in the abstract
Final TIMI flow grade 3
P = 0.011
- TA failure independently associated with low final TIMI flow grade (risk ratio 1.525; 95% CI 1.048-2.218)
- P = 0.027
Observational data: associations, not effects.
Further findings
Myocardial blush grade, ST-segment resolution, microvascular obstruction
- Failed TA: lower myocardial blush grade, lower ST-segment resolution and higher incidence of microvascular obstruction than successful TA
Factors associated with TA failure
- Old age, Killip class ≥III, vessel tortuosity, calcification and non-LAD culprit vessel associated with TA failure
Original publication
Failed Thrombus Aspiration and Reduced Myocardial Perfusion in Patients With STEMI and Large Thrombus Burden. JACC Cardiovasc Interv. Published 18 September 2024. doi:10.1016/j.jcin.2024.07.016
Summarised from the published abstract; every number is checked against it