Thrombus aspiration in patients with ST-elevation myocardial infarction: results of a national registry of interventional cardiology

Pereira, Hélder; Caldeira, Daniel; Teles, Rui Campante; Costa, Marco; Silva, Pedro Canas da; Ribeiro, Vasco da Gama; Brandão, Vítor; Martins, Dinis; Matias, Fernando; Pereira-Machado, Francisco; Baptista, José; Abreu, Pedro Farto e; Santos, Ricardo; Drummond, António; Carvalho, Henrique; Calisto, João; Silva, João Carlos; Pipa, João; Marques, Jorge; Sousa, Paulino; Fernandes, Renato; Ferreira, Rui Cruz; Ramos, Sousa; Oliveira, Eduardo Infante de; Almeida, Manuel

doi:10.1186/s12872-018-0794-4

Cited by 5 publications

(3 citation statements)

References 26 publications

(19 reference statements)

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“… 10 , 11 A recent study suggested that selective TA may be useful for improving the outcomes in patients with STEMI. 12 In the setting of STEMI, the TIMI flow grade could be a surrogate to identify a high thrombus burden. In patients with STEMI and an initial TIMI flow grade from 0 to 1 during PPCI, TA improved coronary flow, myocardial perfusion, and long-term clinical outcome.…”

Section: Discussionmentioning

confidence: 99%

Thrombus aspiration during primary percutaneous coronary intervention improved outcome in patients with STEMI and a large thrombus burden

et al. 2021

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Background The benefit of thrombus aspiration (TA) during primary percutaneous coronary intervention (PPCI) to patients with ST-segment elevation myocardial infarction (STEMI) remains controversial. This study aimed to assess TA's impact on the outcome and prognosis for patients with STEMI and a large thrombus burden during PPCI. Methods This retrospective study evaluated consecutive patients with STEMI and a large thrombus burden (thrombolysis in myocardial infraction [TIMI] thrombus grade ≥4) who underwent conventional PPCI (n = 126) or PPCI + TA (n = 208) between February 2017 and January 2019. The procedure outcome and clinical prognosis were compared. Results Postprocedural vessel diameter was larger, and corrected TIMI frame count (cTFC) was lower in the PPCI + TA compared with the PPCI group. The proportion of postprocedural TIMI 3 flow was 83.3% in the PPC group and 94.2% in the PPCI+TA group. During the 12-month follow-up, no significant differences existed in the incidence of cardiac death, reinfarction, stent thrombosis, target vessel revascularization, or stroke. Conclusion Application of TA in patients with STEMI and a large thrombus burden during PPCI may improve the procedural outcome, but it showed no benefit on the clinical prognosis in the 12-month follow-up. Longer follow-up studies are needed to confirm TA's clinical implications in patients with STEMI.

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Section: Discussionmentioning

confidence: 99%

Thrombus aspiration during primary percutaneous coronary intervention improved outcome in patients with STEMI and a large thrombus burden

et al. 2021

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“…The capabilities of RRCTs in clinical research were initially demonstrated via two landmark cardiology studies, the SAFE-PCI for Women trial (Study of Access Site for Enhancement of Percutaneous Coronary Intervention for women) and the TASTE trial (Thrombus Aspiration during ST-Elevation myocardial infarction in Scandinavia). 4,5 These practice-changing studies utilized comprehensive national registries, were able to collect high-quality patient data on 9458 and 7244 patients, respectively, and were completed at a fraction of the cost of standard RCTs.…”

Section: Benefitsmentioning

confidence: 99%

Registry randomized controlled trials: the future of surgical trials?

Arafat

Wei

Karanatsios

et al. 2023

ANZ Journal of Surgery

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Definition and backgroundRandomized controlled trials (RCTs) provide the highest level of evidence in clinical research and are the foundation of evidencebased medicine. 1 However, ongoing challenges continue to face surgical trials. These include the small number of studies relative to the number of important questions, the fact that many studies fail to recruit, as well as the uncertain applicability of outcome data to real-world practice due to often stringent eligibility criteria. 2 In addition, a major factor with limiting trial initiation is the cost of traditional RCTs, a significant component of which is associated with data collection.Clinical registries are databases that collect patient, treatment and outcome data in routine care, potentially supporting a large range of research and audit projects. An emerging clinical trial methodology, the registry-based randomized controlled trial (RRCT), has been introduced to reduce barriers to opening trials, particularly to reduce costs and to facilitate the enrolment of more real-world patients. This pragmatic study design utilizes registry databases to collect trial outcome data, with patients randomized between current standard-ofcare treatment options. 3,4 Registry databases can also be used to identify trial candidates. With typically broad entry criteria RRCTs support high-quality outcome data being captured in the clinical registry, obtained from enrolled patients representative of the "real world" population.

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“…30 The authors cited the examples of the Study of Access Site for Enhancement of percutaneous coronary intervention (SAFE-PCI) and Thrombus Aspiration in ST-Elevation Myocardial Infarction in Scandinavia (TASTE) trials, both in cardiology, which utilized registry data from 9,458 and 7,244 patients, respectively, for randomized controlled trials. 31,32 The pediatric surgical community has recognized the benefits of registries for rare diseases, and as a result, the European community is in the process of establishing benchmarks for future research projects.…”

Section: Pediatric Surgery and Research Limitationsmentioning

confidence: 99%

Benchmarks for Pediatric Surgical Registries: Recommendations for the Assessment and Grading of Complications

Madadi-Sanjani,

Ure

2023

Eur J Pediatr Surg

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Procedure-related registries in general surgical practice offer a platform for prospective trials, the pooling of data, and detailed outcome analysis. Recommendations by IDEAL and Outcome4Medicine have further improved the uniform reporting of complications and adverse events. In the pediatric surgical network, disease-specific registries for rare and inherited congenital anomalies are gaining importance, fostering international collaborations on studies of low-incidence diseases. However, to date, the reporting of complications in the pediatric surgical registries has been inconsistent. Therefore, the European Reference Network for Inherited and Congenital Anomalies (ERNICA) recently endorsed the validation of the first severity grading system for children. The planned reform of the European Pediatric Surgical Audit (EPSA) registry, which includes the implementation of the Clavien-Madadi classification, represents a further effort to establish uniform outcome reporting. This paper provides an overview of experiences with surgical registries and complication reporting, along with the potential application of this knowledge to future pediatric surgical practice.

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Thrombus aspiration in patients with ST-elevation myocardial infarction: results of a national registry of interventional cardiology

Cited by 5 publications

References 26 publications

Thrombus aspiration during primary percutaneous coronary intervention improved outcome in patients with STEMI and a large thrombus burden

Thrombus aspiration during primary percutaneous coronary intervention improved outcome in patients with STEMI and a large thrombus burden

Registry randomized controlled trials: the future of surgical trials?

Benchmarks for Pediatric Surgical Registries: Recommendations for the Assessment and Grading of Complications

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