Have Thrombus aspiration of NSTEMI patients before PCI?

TATORT-NSTEMI trial 12 months follow-up: NSTEMI patients with pre-PCI thrombosis without benefit

The 12-month follow-up of the TATORT-NSTEMI trial showed that conventional thrombus aspiration in patients with non-ST-elevation myocardial infarction (NSTEMI) failed to improve clinical outcomes. The results of the randomized trial were published on November 19, “European Heart Journal: Acute Cardiovascular Care”. Short-term results of the TATORT-NSTEMI trial showed that conventional thrombus aspiration before PCI did not reduce microvascular occlusion and detectable thrombosis in NSTEMI patients compared with PCI alone.

Some trials, such as the TASTE and TOTAL trials, show that conventional thrombus aspiration in patients with STEMI at direct PCI did not further improve patient outcomes. Recent European and American guidelines do not recommend STEMI patients routinely receive thrombosis. Dr. Holger Thiele (Heart Center, University of Leipzig, Germany) noted that thrombolysis did not yield any additional benefit in combination with the TATORT-NSTEMI trial and some previous major trials, both in NSTEMI and STEMI patients.

Patients with DSTEMI were randomly assigned to both groups, with standard PCI (N = 219) and pre-PCI thrombosis + PCI (N = 221), respectively.

Overall, 11% (48 patients) had primary end points – major adverse cardiac events (MACE), including all-cause death, myocardial infarction, target vessel revascularization, and congestive heart failure; two groups of 12 months (RR 0.63, 95% CI 0.35-1.12; P = 0.11), and the incidence of MACE components between the two groups was 13.4% and 8.7% (RR 0.63, 95% CI 0.35-1.12; P = 0.11) in the standard PCI group and the thrombus aspiration group There was no significant difference.

Further subgroup analyzes based on age, gender, diabetes, GRACE score, TIMI thrombosis grade, pre-PCI TIMI blood flow, direct stent implantation, and GP IIb / IIIa inhibitor use showed similar rates of MACE among different groups All P> 0.05).

The results of this study can not deny that thrombus aspiration can be beneficial in certain patients.

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