Thrombus aspiration in primary percutaneous coronary intervention in acute ST-elevation myocardial infarction patients with high thrombus burden: one-year outcomes in a tertiary healthcare center in Ho Chi Minh City.

Duy Cao Phuong Le, Giang Thai Pham, Quan Duy Vo
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Abstract

Background: Primary percutaneous coronary intervention (PCI) can dislodge atherosclerotic debris, risking microvascular embolism. Thrombus aspiration (TA) before stenting in ST-segment elevation myocardial infarction (STEMI) patients has been linked to reduced mortality, lower recurrence of heart attacks, and improved cardiac function. However, limited research exists on the effectiveness of TA in Vietnam, underscoring the need for further studies to enhance cardiovascular care. This prospective observational study was conducted to evaluate the role of TA in STEMI patients admitted with a substantial thrombus burden at Nguyen Tri Phuong Hospital.

Results: Out of 92 participants, 68 underwent TA treatment. Post-treatment, the TA group exhibited better TIMI and TMP flow grades and a higher rate of ST-segment normalization, with no significant difference in major adverse cardiac events (MACEs) at 30-day and 12-month follow-ups compared to those untreated.

Conclusions: TA during PCI enhances ST-segment normalization and TIMI and TMP scores in STEMI patients, improving myocardial perfusion. No difference in MACE occurrence was noted between groups after 30 days and 12 months, suggesting TA's potential benefits without increasing adverse outcomes.

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高血栓负担急性st段抬高型心肌梗死患者经皮冠状动脉介入治疗中血栓吸出:胡志明市三级医疗中心的一年结果
背景:初级经皮冠状动脉介入治疗(PCI)可以清除动脉粥样硬化碎片,有微血管栓塞的风险。st段抬高型心肌梗死(STEMI)患者支架植入术前血栓抽吸(TA)与降低死亡率、降低心脏病发作复发率和改善心功能有关。然而,关于TA在越南的有效性的研究有限,强调需要进一步研究以加强心血管护理。这项前瞻性观察性研究旨在评估TA在Nguyen Tri Phuong医院住院的具有大量血栓负担的STEMI患者中的作用。结果:92名参与者中,68名接受了TA治疗。治疗后,TA组表现出更好的TIMI和TMP血流等级和更高的st段正常化率,在30天和12个月的随访中,与未治疗组相比,主要不良心脏事件(mace)无显著差异。结论:PCI时TA可增强STEMI患者st段正常化及TIMI、TMP评分,改善心肌灌注。30天和12个月后,两组间MACE的发生率没有差异,这表明TA的潜在益处不会增加不良后果。
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