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OUR MISSION: TO REDUCE THE BURDEN OF CARDIOVASCULAR DISEASE
Dr. Bo Lagerqvist
Prof. Gilles Montalescot,
By Bo Lagerqvist, (Uppsala, Sweden)View Discussant report
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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, Sweden2) 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.
BackgroundThe 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.MethodsTASTE 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. ResultsNo 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). ConclusionsThrombus aspiration as a routine adjunct to primary PCI does not reduce mortality or ischemic events on long term.
By Gilles Montalescot, FESC (Paris, France)See Presenter abstract
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Clinical Trial Update Hot Line: Infarction, interventions and outcome
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