Comparison Of The Prognostic Value Of Aspiration Thrombectomy With Primary PCI And PCI Alone In Patients With STEMI-the Single Center Analysis Of TOTAL Research

Objective: To determine the prognostic value of stent implantation after using Export thrombus aspiration catheter in the treatment of thrombotic lesions on myocardial perfusion and clinical outcomes in patients with STEMI undergoing PCI.Methods: A total number of 358 patients with ST-elevation myocardial infarction enrolled at Shanghai Tenth People’s Hospital were randomly assigned in a 1:1 ratio to either thrombus aspiration group(n=179) or conventional treatment group(n=179) before undergoing initial coronary angiography. The preprocedural and postprocedural TIMI flow, peak values of CK-MB and c Tn T and summed STR across all infarct-related ECG leads were recorded to explore the effects of aspiration thrombectomy with primary PCI on myocardial perfusion. Major adverse cardiac events(MACE) were analyzed to determine the prognostic value of aspiration thrombectomy with primary PCI.Result: Patients in the aspiration group had significantly lower peak values of CK-MB and c Tn T compared with the control group(p < 0.01). ST-segment resolution markedly improved in the the aspiration group(p<0.05). Moreover, the aspiration group had a higher rate of postprocedural TIMI3 flow when compared with control group(p<0.01). However, no significance was detected between two groups in the incidence of MACE during 1 year follow-up(p=0.764).Conclusion: Compared with conventional PCI, thrombus aspiration before stent implantation in the infarcted artery could significantly reduce the occurrence of no reflow and slow blood flow phenomenon,to improve the myocardial perfusion and reduce the area of myocardial infarction in STEMI patients; But on long-term clinical outcomes,there are no significant difference Between the two surgical methods.