OR31. Effect of Selective Thrombus Aspiration on Clinical Outcomes in Patients with ST-Segment Elevation Acute Coronary Syndrome Undergoing Primary Percutaneous Coronary Intervention

Abstract

Abstract Aims Manual thrombus aspiration (TA) can reduce distal embolization and improve microvascular perfusion in patients with ST-segment elevation acute coronary syndrome (STE-ACS), especially in patients with high thrombus burden. The aim of this study is to determine the effect of selective TA on clinical outcomes after primary PCI. Methods and Results A retrospective cohort study was performed on STE-ACS patients within 12 hours onset and initial TIMI Thrombus grade ≥3 undergoing primary PCI and selective TA in Dr. Kariadi General Hospital from January 2016 to December 2019. The measured clinical outcome was in-hospital MACE which consisted of mortality, cardiogenic shock, acute lung oedema, arrhythmia, urgent revascularization, and stroke. There were 196 patients fulfiling the criteria, consisted of 96 patients in TA group and 100 patients in non-TA group. Angiographic success in TA group was 97.9%. TA group achieved a better reduction of TIMI thrombus than in non-TA group (4.31 vs 4.11, p = 0.012). There were 15 patients in TA group (15.6%) and 20 patients in non-TA group (20%) who experienced in-hospital MACE after primary PCI (RR 1.055, 95% CI 0.926-1.202, p = 0.424). In patients with initial TIMI Thrombus grade 5, MACE in TA group occurred less than non-TA group (13.2% vs 42.9%, p = 0.01). Conclusions Selective TA did not affect in-hospital MACE after primary PCI. In patients with initial TIMI Thrombus Grade 5, TA might be beneficial to reduce MACE after primary PCI.