No beneficial effects of coronary thrombectomy on left ventricular systolic and diastolic function in patients with acute S-T elevation myocardial infarction: a randomized clinical trial.

OBJECTIVE

We sought to evaluate the effect of acute coronary thrombectomy, as adjunctive treatment to primary percutaneous coronary intervention, on the systolic and diastolic left ventricular function, in patients with acute S-T elevation myocardial infarction.

METHODS

In a prospective randomized study, patients with acute S-T elevation myocardial infarction were randomized to treatment with primary percutaneous coronary intervention with or without thrombectomy. Outcome measures were left ventricular volumes and ejection fraction in addition to systolic long-axis function, estimated from the tissue Doppler systolic velocities of the mitral ring. Diastolic function was assessed by mitral inflow and diastolic velocities of the mitral ring movement.

RESULTS

Of the 215 patients included, 172 patients (80%) had a 30-day follow-up. There were no significant differences in ejection fraction between groups during follow-up (thrombectomy at baseline 47 +/- 14% vs 47 +/- 14% at follow-up, control group at baseline 48 +/- 11% vs 51 +/- 12% at follow-up, P = not significant). Systolic velocities were significantly higher in the control group at follow-up (thrombectomy, at baseline, 6.5 +/- 1.9 vs 6.3 +/- 1.8 cm/s at follow-up; control group, at baseline, 6.5 +/- 1.9 vs 7.0 +/- 1.9 cm/s at follow-up; P < .05). There were no significant differences in diastolic function between the two groups.

CONCLUSION

Thrombectomy had no beneficial effect on the left ventricular function in patients with acute S-T elevation myocardial infarction.