Prognosis of in-hospital and long-term after thrombus aspiration in acute ST-segment elevation myocardial infarction
WANG Gang
ZHAO Hui-qiang
LIU Rui-feng
Abstract：Objective To evaluate the short-term and long-term efficacy of thrombus aspiration in ST-segment elevation myocardial infarction(STEMI)patients with high thrombus burden.Methods 318 STEMI patients who underwent emergency percutaneouscoronary intervention(PCI)from January 2015 to December 2018 were included.The patients were divided into the thrombus aspiration group(159 cases)and the non-thrombus aspiration group(159 cases)based on whether thrombus aspiration was performed.The general clinical data,thrombus burden classification and procedural details were collected,and the major adverse cardiovascular events(MACE)were followed up by outpatients and telephone.Kaplan-Meier survival analysis was used to assess the impact of thrombus aspiration on short-term and 5-years'long-term outcomes.Results The proportion of patients with high thrombus burden was significantly higher in the thrombus aspiration group compared to the non-thrombus aspiration group(23.27%vs.0%,P<0.001).The peak levels of creatine kinase-MB and troponin I(indicating infarct size)were significantly higher in the thrombus aspiration group(P=0.001 and P<0.001,respectively).No significant differences were observed between the two groups in most other clinical characteristics and treatment strategies.Kaplan-Meier survival analysis showed that the probability of not experiencing MACE during follow-up was not significantly different between the 2 groups(P=0.557).Further analysis based on thrombus burden revealed no statistically significant difference in long-term survival probability between the high thrombus burden and low thrombus burden groups(P=0.149).Conclusion Among STEMI patients,the thrombus aspiration group shows slightly worse in-hospital outcomes(indicating larger infarct size),but no significant difference in long-term prognosis.It is hypothesized that thrombus aspiration may have improved the poorer long-term outcomes in this population.For patients with high thrombus burden,the use of thrombus aspiration should be carefully considered based on individual circumstances.
Keywords：Acute ST-segment elevation myocardial infarctionThrombus aspirationPercutaneous coronary interventionThrombus burdenMajor adverse cardiovascular events
Publication Date：2025-08-20
Online Publishing Date：2025-09-05(First online date of this platform, not the publication date of the document)
Pages：6( 728-733 )