One-year survival according to use of thrombus aspiration for primary PCI in the real-world. The FAST-MI 2010 registry

Abstract

Background: Whether the use of thrombus aspiration during primary PCI for STEMI is associated with decreased mortality remains a matter of debate. We assessed one-year survival in STEMI patients participating in the FAST-MI 2010 registry according to use of thrombus aspiration during primary PCI. Methods: FAST-MI 2010 is a nationwide French registry that included 4169 patients with AMI at the end of 2010 in 213 centres (76% of active centres in France). Of those, 2438 had STEMI or LBBB, of whom 1497 had primary PCI, with thrombus aspiration used in 663 (44%). Results: Patients with thrombus aspiration were younger (61 vs 63 yrs, P=0.01), with a similar GRACE score (140 vs 143, P=0.10) and a shorter median time from symptom onset (245 vs 285 min, P=0.001), and they were more often admitted to academic hospitals (46% vs 35%, P<0.001); location of AMI, history of MI, PCI or CABG did not differ significantly. Thirty-day mortality was 2.1% vs 2.3% (P=0.71) and one-year survival was 95.5% vs 94.8%, P=0.59. Using fully adjusted Cox multivariate analysis HR (95% CI) for one-year death was 1.02 (0.54-1.91), P=0.96. A propensity score for getting thrombus aspiration was calculated and two groups of 550 patients each with similar baseline characteristics were compared: 30-day death was 1.1 vs 1.5% (P=0.59), and one-year survival was 96.4 vs 96.2%, P=0.90 (Figure) ![Figure][1] One-year survival in matched cohorts Conclusion: The use of thrombus aspiration in this real-world setting was not associated with improved one-year survival. [1]: pending:yes