New research confirms thrombus aspiration (TA) during percutaneous coronary intervention (PCI) 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 PCI, thrombectomy does not affect rates of major adverse cardiac events at two-year follow-up.
The World Health Organization (WHO) reports that cardiovascular diseases are the number one cause of death worldwide, and by 2030 nearly 24 million people will die, primarily from heart disease and stroke. PCI, known also as angioplasty, is used to open blocked arteries to restore blood flow and more than one million Americans have this procedure each year according to the National Heart, Lung, and Blood Institute.
For the current study, Dr. Maarten Vink and colleagues in The Netherlands analyzed data from the PASSION trial to evaluate long-term outcomes with TA versus standard PCI with stents. As part of the trial 619 STEMI patients were randomized to paclitaxel-eluting or bare-metal stents, with TA performed in just over half of participants (311). Long-term outcomes that included cardiac death, recurrent myocardial infarction (MI), or target-lesion revascularization (TLR) were compared between patients undergoing TA compared to conventional PCI.
Two-year follow-up was completed for 598 patients. Cumulative incidence of cardiac death, recurrent MI, and TLR was found in 13% of TA patients and 13.5% of participants in the conventional PCI group. TLR incidence was comparable in the TA and standard PCI 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 TA in conjunction with PCI did not affect the incidence of adverse cardiac events at the two-year follow-up compared to conventional PCI," concludes Dr. Vink "We observed no difference in stent thrombosis between the two groups."
This study is published in Catheterization and Cardiovascular Interventions. Media wishing to receive a PDF of this article may contact healthnews@wiley.com
Full citation: "Lack of Long-Term Clinical Benefit of Thrombus Aspiration during Primary Percutaneous Coronary Intervention With Paclitaxel-Eluting Stents or Bare-Metal Stents: Post-Hoc Analysis of the PASSION-Trial." Maarten A. Vink, Maurits T. Dirksen, Jan G.P. Tijssen, Maarten J. Suttorp, Mark S. Patterson, Nan van Geloven, Alexander J. Ijsselmuiden, Ton Slagboom, Ferdinand Kiemeneij and Gerrit J. Laarman. Catheterization and Cardiovascular Interventions; Published Online: December 12, 2011 (DOI: 10.1002/ccd.23226); Print Issue Date: May 2012. URL: http://onlinelibrary.wiley.com/doi/10.1002/ccd.23226/abstract
Catheterization and Cardiovascular Interventions is the official journal of The Society for Cardiovascular Angiography and Interventions. This international journal covers the broad field of cardiovascular diseases. Subject material includes basic and clinical information that is derived from or related to invasive and interventional coronary or peripheral vascular techniques. The journal focuses on material that will be of immediate practical value to physicians providing patient care in the clinical laboratory setting. To accomplish this, the journal publishes Preliminary Reports and Work In Progress articles that complement the traditional Original Studies, Case Reports, and Comprehensive Reviews. Perspective and insight concerning controversial subjects and evolving technologies are provided regularly through Editorial Commentaries furnished by members of the Editorial Board and other experts. Articles are subject to double-blind peer review and complete editorial evaluation prior to any decision regarding acceptability. For more information, please visit http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)1522-726X.
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Catheterization and Cardiovascular Interventions