TY - JOUR
T1 - Long-term outcome after thrombus aspiration in non-ST-elevation myocardial infarction - results from the TATORT-NSTEMI trial: Thrombus aspiration in acute myocardial infarction
AU - Feistritzer, Hans Josef
AU - Meyer-Saraei, Roza
AU - Lober, Christiane
AU - Böhm, Michael
AU - Scheller, Bruno
AU - Lauer, Bernward
AU - Geisler, Tobias
AU - Gawaz, Meinrad
AU - Bruch, Leonhard
AU - Klein, Norbert
AU - Zeymer, Uwe
AU - Eitel, Ingo
AU - Jobs, Alexander
AU - Freund, Anne
AU - Desch, Steffen
AU - de Waha-Thiele, Suzanne
AU - Thiele, Holger
N1 - Funding Information:
Supported by Terumo Europe, Leuven, Belgium and Alliance of Daiichi Sankyo Germany GmbH, Munich and Lilly Germany GmbH, Bad Homburg.
Publisher Copyright:
© 2020, Springer-Verlag GmbH Germany, part of Springer Nature.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/10/1
Y1 - 2020/10/1
N2 - Aims: To investigate the long-term prognostic value of aspiration thrombectomy in conjunction with primary percutaneous coronary intervention (PCI) compared to conventional PCI in patients with non-ST-elevation myocardial infarction (NSTEMI). Methods: In the randomized TATORT-NSTEMI (Thrombus aspiration in thrombus containing culprit lesions in non-ST-elevation myocardial infarction) trial, NSTEMI patients with thrombus containing culprit lesions were randomized to either PCI with aspiration thrombectomy or conventional PCI. The endpoint was a combination of all-cause death, reinfarction and new congestive heart failure. Results: From 440 patients initially randomized, outcome data were available in 432 (98.2%) patients at a median follow-up of 4.9 (interquartile range [IQR] 4.4–5.0) years. Thrombectomy was associated with a significant reduction of the combined endpoint compared to conventional PCI (19.9% vs. 30.7%, p = 0.01). This finding was primarily driven by a reduced rate of reinfarction with thrombectomy (3.4% vs. 10.3%, p = 0.01). Thrombectomy was still independently associated with the combined endpoint after multivariable adjustment (hazard ratio [HR] 0.47, 95% confidence interval [CI] 0.30–0.76, p = 0.002). Findings were consistent across all analyzed subgroups (p values for interaction all ' 0.05). Conclusions: In NSTEMI, thrombus aspiration is associated with favorable clinical outcome during long-term follow-up. Clinical trial registration: NCT01612312.
AB - Aims: To investigate the long-term prognostic value of aspiration thrombectomy in conjunction with primary percutaneous coronary intervention (PCI) compared to conventional PCI in patients with non-ST-elevation myocardial infarction (NSTEMI). Methods: In the randomized TATORT-NSTEMI (Thrombus aspiration in thrombus containing culprit lesions in non-ST-elevation myocardial infarction) trial, NSTEMI patients with thrombus containing culprit lesions were randomized to either PCI with aspiration thrombectomy or conventional PCI. The endpoint was a combination of all-cause death, reinfarction and new congestive heart failure. Results: From 440 patients initially randomized, outcome data were available in 432 (98.2%) patients at a median follow-up of 4.9 (interquartile range [IQR] 4.4–5.0) years. Thrombectomy was associated with a significant reduction of the combined endpoint compared to conventional PCI (19.9% vs. 30.7%, p = 0.01). This finding was primarily driven by a reduced rate of reinfarction with thrombectomy (3.4% vs. 10.3%, p = 0.01). Thrombectomy was still independently associated with the combined endpoint after multivariable adjustment (hazard ratio [HR] 0.47, 95% confidence interval [CI] 0.30–0.76, p = 0.002). Findings were consistent across all analyzed subgroups (p values for interaction all ' 0.05). Conclusions: In NSTEMI, thrombus aspiration is associated with favorable clinical outcome during long-term follow-up. Clinical trial registration: NCT01612312.
UR - http://www.scopus.com/inward/record.url?scp=85079873255&partnerID=8YFLogxK
U2 - 10.1007/s00392-020-01613-0
DO - 10.1007/s00392-020-01613-0
M3 - Journal articles
C2 - 32030497
AN - SCOPUS:85079873255
SN - 1861-0684
VL - 109
SP - 1223
EP - 1231
JO - Clinical Research in Cardiology
JF - Clinical Research in Cardiology
IS - 10
ER -