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Title: 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, H.
Shiomi, H.
Nakatsuma, K.
Morimoto, T.
Taniguchi, T.
Furukawa, Y.
Nakagawa, Y.
Horie, M.
Kimura, T.
Kimura, T.
Sakata, R.
Marui, A.
Matsuda, M.
Mitsuoka, H.
Onoe, M.
Nakagawa, Y.
Yamanaka, K.
Fujiwara, H.
Takatsu, Y.
Ohno, N.
Nohara, R.
Murakami, T.
Takeda, T.
Nobuyoshi, M.
Iwabuchi, M.
Hanyu, M.
Tatami, R.
Matsushita, T.
Shirotani, M.
Nishiwaki, N.
Kita, T.
Furukawa, Y.
Okada, Y.
Kato, H.
Eizawa, H.
Is, K.
Tanaka, M.
Nakayama, S.
Lee, J.-D.
Nakano, A.
Koshiji, T.
Morioka, K.
Takizawa, A.
Shimamoto, M.
Yamazaki, F.
Takahashi, M.
Nishizawa, J.
Horie, M.
Takashima, H.
Tamura, T.
Aota, M.
Takahashi, M.
Tabata, T.
Tei, C.
Hamasaki, S.
Imoto, Y.
Yamamoto, H.
Kambara, H.
Doi, O.
Matsuda, K.
Nara, M.
Mitsudo, K.
Kadota, K.
Komiya, T.
Miki, S.
Mizoguchi, T.
Nakajima, H.
Ogawa, H.
Sugiyama, S.
Kawasuji, M.
Moriyama, S.
Hattori, R.
Aoyama, T.
Araki, M.
Suwa, S.
Tanbara, K.
Kitagawa, K.
Yamauchi, M.
Okamoto, N.
Fujino, Y.
Tezuka, S.
Saeki, A.
Hanazawa, M.
Sato, Y.
Hibi, C.
Sasae, H.
Takinami, E.
Uchida, Y.
Yamamoto, Y.
Nishida, S.
Yoshimoto, M.
Maeda, S.
Miki, I.
Minematsu, S.
Abe, M.
Shiomi, H.
Tada, T.
Tazaki, J.
Kato, Y.
Hayano, M.
Tokushige, A.
Natsuaki, M.
Nakajima, T.
Author's alias: 田﨑, 淳一
Keywords: acute coronary syndrome
coronary artery disease
no reflow
percutaneous coronary intervention
thrombus aspiration
Issue Date: 15-Jun-2015
Publisher: American Heart Association, Inc.
Journal title: Journal of the American Heart Association
Volume: 4
Issue: 6
Thesis number: e001962
Abstract: 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.
Rights: © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
URI: http://hdl.handle.net/2433/218362
DOI(Published Version): 10.1161/JAHA.115.001962
PubMed ID: 26077588
Appears in Collections:Journal Articles

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