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dc.contributor.authorRajakariar, K.
dc.contributor.authorAndrianopoulos, N.
dc.contributor.authorGayed, D.
dc.contributor.authorLiang, D.
dc.contributor.authorBackhouse, B.
dc.contributor.authorAjani, A.E.
dc.contributor.authorDuffy, S.J.
dc.contributor.authorBrennan, A.
dc.contributor.authorRoberts, L.
dc.contributor.authorReid, Christopher
dc.contributor.authorOqueli, E.
dc.contributor.authorClark, D.
dc.contributor.authorFreeman, M.
dc.date.accessioned2023-11-14T07:13:20Z
dc.date.available2023-11-14T07:13:20Z
dc.date.issued2023
dc.identifier.citationRajakariar, K. and Andrianopoulos, N. and Gayed, D. and Liang, D. and Backhouse, B. and Ajani, A.E. and Duffy, S.J. et al. 2023. Outcomes of thrombus aspiration during primary percutaneous coronary intervention for ST-elevation myocardial infarction. Internal Medicine Journal. 53 (8): pp. 1376-1382.
dc.identifier.urihttp://hdl.handle.net/20.500.11937/93766
dc.identifier.doi10.1111/imj.15828
dc.description.abstract

Background: Previous large multi-centre randomised controlled trials have not provided clear benefit with routine intracoronary thrombus aspiration (TA) as an adjunct to primary percutaneous coronary intervention (PCI) in patients with ST-elevation myocardial infarction (STEMI). Aim: To determine whether there is a difference in outcomes with the use of manual TA prior to PCI, compared with PCI alone in a cohort of patients with STEMI. Methods: We analysed data from 6270 consecutive patients undergoing primary PCI for STEMI prospectively enrolled in the Melbourne Interventional Group registry between 2007 and 2018. Multivariable analysis was performed to determine predictors of 30-day major adverse cardiovascular and cerebrovascular events (MACCE) and long-term mortality. Results: We compared 1621 (26%) patients undergoing primary PCI with TA to 4649 (74%) patients undergoing PCI alone. Male gender (81% vs 78%; P < 0.01), younger age (61 vs 63 years; P = 0.03), GP-IIb/IIIa use (76% vs 58%, P < 0.01), and current smoking (40% vs 36%; P < 0.01) were more common in the TA group. TA was more likely to be used in patients with complex lesions (83% vs 66%; P < 0.01) with TIMI 0 flow (77% vs 56%; P < 0.01). No significant difference in post-procedural TIMI flow, stroke, 30-day mortality, or long-term mortality were identified. Multivariable analysis demonstrated a reduction in 30-day MACCE (hazard ratio (HR) 0.75; confidence interval (CI) 0.63–0.89; P < 0.01) in the TA group, but was not associated with long-term mortality (HR 0.98; CI 0.85–1.1; P = 0.73). Conclusion: The use of TA in patients undergoing primary PCI for STEMI was not associated with improved short or long-term mortality when compared with PCI alone.

dc.languageEnglish
dc.publisherWILEY
dc.relation.sponsoredbyhttp://purl.org/au-research/grants/nhmrc/1111170
dc.relation.sponsoredbyhttp://purl.org/au-research/grants/nhmrc/1045862
dc.subjectScience & Technology
dc.subjectLife Sciences & Biomedicine
dc.subjectMedicine, General & Internal
dc.subjectGeneral & Internal Medicine
dc.subjectthrombectomy
dc.subjectthrombus aspiration
dc.subjectSTEMI
dc.subjectprimary PCI
dc.subjectNO-REFLOW
dc.subjectTHROMBECTOMY
dc.subjectANGIOPLASTY
dc.subjectREPERFUSION
dc.subjectABCIXIMAB
dc.subjectTHERAPY
dc.subjectTIME
dc.subjectPCI
dc.subjectSTEMI
dc.subjectprimary PCI
dc.subjectthrombectomy
dc.subjectthrombus aspiration
dc.subjectHumans
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectCoronary Thrombosis
dc.subjectPercutaneous Coronary Intervention
dc.subjectST Elevation Myocardial Infarction
dc.subjectThrombectomy
dc.subjectTreatment Outcome
dc.subjectClinical Trials as Topic
dc.subjectHumans
dc.subjectCoronary Thrombosis
dc.subjectTreatment Outcome
dc.subjectThrombectomy
dc.subjectMiddle Aged
dc.subjectMale
dc.subjectClinical Trials as Topic
dc.subjectPercutaneous Coronary Intervention
dc.subjectST Elevation Myocardial Infarction
dc.titleOutcomes of thrombus aspiration during primary percutaneous coronary intervention for ST-elevation myocardial infarction
dc.typeJournal Article
dcterms.source.volume53
dcterms.source.number8
dcterms.source.startPage1376
dcterms.source.endPage1382
dcterms.source.issn1444-0903
dcterms.source.titleInternal Medicine Journal
dc.date.updated2023-11-14T07:13:20Z
curtin.departmentCurtin School of Population Health
curtin.accessStatusFulltext not available
curtin.facultyFaculty of Health Sciences
curtin.contributor.orcidReid, Christopher [0000-0001-9173-3944]
dcterms.source.eissn1445-5994
curtin.repositoryagreementV3


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