AMSTERDAM, The Netherlands -- Aspiration of the blood clot or "thrombus" that causes a heart attack before re-opening a patient's artery with a balloon catheter does not improve survival compared to performing balloon dilation and stenting alone according to the results of the Thrombus Aspiration in ST- Elevation myocardial infarction in Scandinavia (TASTE) trial.
"We believe that TASTE questions the usefulness of thrombus aspiration as a routine adjunct and the recommendation for its general use in international guidelines should probably be down-graded," said lead author Ole Frbert, MD, PhD, from the Department of Cardiology at rebro University Hospital, in rebro, Sweden.
The multicenter, prospective, randomized, controlled open-label trial enrolled 7244 patients with STEMI from Sweden, Denmark and Iceland who had a diagnosis of ST-elevation myocardial infarction (STEMI).
Half of the patients were assigned to balloon treatment only (known as percutaneous coronary intervention, or PCI) and the other half had their blood clot aspirated before PCI.
The mortality rate at 30 days post-surgery procedure was not statistically different between the groups (3.0% versus 2.8% respectively).
Similarly, there was no difference between the two groups for secondary endpoints including risk of new heart attack, stroke and complications related to the treatment.Even high risk groups such as smokers, patients with diabetes or patients with large clots had similar results with either approach.
"Our findings do not support a role for this additional procedure as a routine future treatment," said Dr. Frbert.
The study results will likely have an immediate impact on clinical practice, he added.
Current European Society of Cardiology guidelines on treatment of patients with ST-elevation myocardial infarction (STEMI) recommend that thrombus aspiration should be considered and "most opinion leaders advocate
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European Society of Cardiology