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Clot Aspiration Improves Outcomes After Heart Attack

Outcomes better than those achieved with conventional percutaneous coronary intervention

WEDNESDAY, Feb. 6 (HealthDay News) -- In patients with a heart attack and ST-segment elevation, aspirating the clots during percutaneous coronary intervention (PCI) results in better reperfusion and clinical outcomes than conventional PCI, according to study findings published in the Feb. 7 issue of the New England Journal of Medicine.

Tone Svilaas, M.D., and colleagues from the University of Groningen in the Netherlands randomly assigned 1,071 patients with myocardial infarction with ST-segment elevation to manual thrombus aspiration during PCI or conventional PCI.

The researchers found that significantly fewer patients in the thrombus aspiration group had a myocardial blush grade of 0 or 1 (17.1 versus 26.3 percent). Lower grades were associated with significantly higher rates of adverse events and higher 30-day mortality rates. Significantly more patients in the thrombus aspiration group had complete resolution of ST-segment elevation (56.6 versus 44.2 percent).

The study shows that "thrombus extraction is conceptually sound and appears to reduce the risk among patients undergoing primary PCI," George W. Vetrovec, M.D., from Virginia Commonwealth University in Richmond, writes in an accompanying editorial.

The study was supported by a grant from Medtronic.

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