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TASTE: One year outcome of The Thrombus Aspiration in ST-Elevation myocardial infarction in Scandinavia trial

ESC Congress 2014 - Hot Line report

Acute Coronary Syndromes (ACS)


 

Presentation

By Bo Lagerqvist, (Uppsala, Sweden)
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List of Authors:
Bo Lagerqvist, MD, PhD,1,2), Ole Fröbert, MD, PhD3), Göran K. Olivecrona, MD, PhD 4), Thórarinn Gudnason, MD, PhD 5), Michael Maeng, MD, PhD 6), Ollie Östlund, MSc 2) Stefan K. James, MD. PhD,1,2)
1) Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden
2) Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden.
3) Department of Cardiology, Örebro University Hospital, Örebro, Sweden.
4) Department of Cardiology, Lund University Hospital Lund, Sweden.
5) Department of Cardiology, Landspitali Univesity Hospital, Reykjavik, Iceland.
6) Department of Cardiology, Skejby Hospital, Aarhus University Hospital, Aarhus, Denmark.

Abstract

Background
The Thrombus Aspiration in ST-Elevation myocardial infarction in Scandinavia (TASTE trial) randomized 7244 patients undergoing primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) to thrombus aspiration before PCI or PCI alone. The 30-day primary endpoint of all-cause mortality did not differ between the randomized groups. Here we report the preliminary 1-year outcome results.
Methods
TASTE introduced the Registry-based Randomized Clinical Trial (RRCT) concept using national registries as on-line platforms for randomization, case record forms and follow-up in Sweden, Denmark and Iceland.
Results
No patients were lost to follow-up for the primary endpoint. All-cause mortality was 5.3% (191 of 3621) in the thrombus aspiration group compared to 5.6% (202 of 3623) in the PCI alone group (hazard ratio (HR) 0.94; 95% confidence interval (CI), 0.78–1.15, P=0.57). Hospitalization for myocardial infarction during one year occurred in 2.7% (96) vs. 2.7% (99) (HR 0.97; 95% CI, 0.73–1.28, P=0.81) and stent thrombosis in 0.7% (27) vs. 0.9 % (32) (HR 0.84; 95% CI, 0.50 - 1.40, P=0.51). The composite of death, myocardial infarction and stent thrombosis occurred in 8.0% (289) vs. 8.5% (307) (HR 0.94; 95% CI 0.80-1.11, P=0.48).
Conclusions
Thrombus aspiration as a routine adjunct to primary PCI does not reduce mortality or ischemic events on long term.

Discussion

By Gilles Montalescot, FESC (Paris, France)
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References


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SessionTitle:

Clinical Trial Update Hot Line: Infarction, interventions and outcome

The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.