Impact of thrombus aspiration in frail STEMI patients

Pasquale Mone, Jessica Gambardella, Antonella Pansini, Mario Rizzo, Ciro Mauro, Fabio Minicucci, Gaetano Santulli

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Despite primary percutaneous coronary intervention (PPCI) is generally considered the best therapy in older frail adults with ST-segment elevation myocardial infarction (STEMI), the incidence of re-hospitalization for cardiovascular diseases remains significant in these patients. Aims: We hypothesized that thrombus aspiration (TA) before PPCI could be a useful treatment for reducing mortality and rehospitalizations in frail patients undergoing PPCI for STEMI. Methods: We conducted a study comparing PPCI alone vs TA + PPCI in frail STEMI patients. We examined a cohort of consecutive frail patients aged ≥ 65 years with first STEMI treated with PPCI between February 2008 and July 2015 at the Department of Cardiology of the “Cardarelli” Hospital in Naples, Italy. Results: The study was completed by 389 patients (PPCI: 195, TA + PPCI: 194). At 1-month follow-up, the rate of death from any cause was 7.0% in patients treated with PPCI alone vs 3.0% in patients treated with TA + PPCI (p 0.036), whereas death from cardiovascular causes was 6.0% in the PPCI group vs 3.0% in the TA + PPCI group (p 0.028). Equally important, the rate of re-hospitalization due to heart failure was 7.5% in the PPCI group vs 4.0% in TA + PPCI group (p 0.025) and the rate of re-hospitalization due to acute coronary syndrome was 10.0% in the PPCI group vs 4.5% in the TA + PPCI group (p 0.016). Conclusion: These results indicate the importance of TA in the treatment of STEMI in a group of high-risk patients such as elderly with frailty.

Original languageEnglish (US)
JournalAging Clinical and Experimental Research
DOIs
StateAccepted/In press - 2021
Externally publishedYes

Keywords

  • Frailty
  • STEMI
  • Thrombus aspiration

ASJC Scopus subject areas

  • Aging
  • Geriatrics and Gerontology

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