[Effect of aspiration of coronary thrombus upon prognosis of patients in primary percutaneous coronary intervention].

Objective: To evaluate the effect of aspiration of coronary thrombus upon the outcome of in-hospital primary percutaneous coronary intervention (PCI) in acute myocardial infarction (AMI) patients.
Methods: A total of 202 AMI patients undergoing primary PCI and receiving aspiration thrombectomy catheter during from December 2007 to November 2008 were enrolled into the study group. And 148 receiving only routine PCI but with similar coronary angiography and basic characteristics were enrolled into the control group. The immediate and in-hospital outcomes were compared between two groups.
Results: There were no significant baseline differences between two groups. Compared with the control group, no-reflow/slow flow (3.5% vs 8.8%, P = 0.038), acute and subacute stent thrombosis (0.5% vs 4.7%, P = 0.011), heart failure (11.4% vs 19.6%, P = 0.035), re-infarction (1.0% vs 6.1%, P = 0.010), in-hospital mortality (3.5% vs 8.8%, P = 0.038), peak level of serum CK-MB (152.0 U/L +/- 73.6 U/L vs 171.0 U/L +/- 71.2 U/L, P = 0.015) and TnI (44.7 microg/L +/- 31.2 microg/L vs 51.9 microg/L +/- 33.6 microg/L, P = 0.041) decreased in the study group. However, stent was directly implanted (44.1% vs 24.3%, P = 0.002), TIMI flow grade 3 was obtained (90.1% vs 81.8%, P = 0.027) and faster ST segment resolution (67.8% vs 53.4%, P = 0.008) improved in the study group.
Conclusion: Application of thrombus aspiration in patients with acute myocardial infarction is effective to decrease no-reflow/slow flow and achieve a better clinical prognosis during hospitalization.