Bin Ning, Zhang Feifei, Song Xuelian, Xie Yuetao, Jia Meixue, Dang Yi
Department of Cardiology, The People's Hospital of Fuyang, Fuyang, Anhui Province, People's Republic of China.
Department of Cardiology Center, Hebei General Hospital, Shijiazhuang, No.348 West Peace Road, Xinhua District, Shijiazhuang, Hebei Province, People's Republic of China.
J Int Med Res. 2021 May;49(5):3000605211012611. doi: 10.1177/03000605211012611.
The benefit of thrombus aspiration (TA) during primary percutaneous coronary intervention (PPCI) to patients with ST-segment elevation myocardial infarction (STEMI) remains controversial. This study aimed to assess TA's impact on the outcome and prognosis for patients with STEMI and a large thrombus burden during PPCI.
This retrospective study evaluated consecutive patients with STEMI and a large thrombus burden (thrombolysis in myocardial infraction [TIMI] thrombus grade ≥4) who underwent conventional PPCI (n = 126) or PPCI + TA (n = 208) between February 2017 and January 2019. The procedure outcome and clinical prognosis were compared.
Postprocedural vessel diameter was larger, and corrected TIMI frame count (cTFC) was lower in the PPCI + TA compared with the PPCI group. The proportion of postprocedural TIMI 3 flow was 83.3% in the PPC group and 94.2% in the PPCI+TA group. During the 12-month follow-up, no significant differences existed in the incidence of cardiac death, reinfarction, stent thrombosis, target vessel revascularization, or stroke.
Application of TA in patients with STEMI and a large thrombus burden during PPCI may improve the procedural outcome, but it showed no benefit on the clinical prognosis in the 12-month follow-up. Longer follow-up studies are needed to confirm TA's clinical implications in patients with STEMI.
在直接经皮冠状动脉介入治疗（PPCI）期间，血栓抽吸术（TA）对ST段抬高型心肌梗死（STEMI）患者的益处仍存在争议。本研究旨在评估TA对PPCI期间STEMI且血栓负荷大的患者的结局和预后的影响。
这项回顾性研究评估了2017年2月至2019年1月期间连续接受常规PPCI（n = 126）或PPCI + TA（n = 208）的STEMI且血栓负荷大（心肌梗死溶栓治疗[TIMI]血栓分级≥4）的患者。比较了手术结局和临床预后。
与PPCI组相比，PPCI + TA组术后血管直径更大，校正的TIMI帧数（cTFC）更低。PPC组术后TIMI 3级血流的比例为83.3%，PPCI + TA组为94.2%。在12个月的随访期间，心脏死亡、再梗死、支架血栓形成、靶血管血运重建或中风的发生率没有显著差异。
在PPCI期间，对STEMI且血栓负荷大的患者应用TA可能改善手术结局，但在12个月的随访中对临床预后没有益处。需要更长时间的随访研究来证实TA对STEMI患者的临床意义。
