Introduction. Data on effects of thrombus aspiration on left ventricular
diastolic function in ST-elevation myocardial infarction (STEMI) population
are scarce. Objective. We sought to compare echocardiographic indices of the
diastolic function and outcomes in STEMI patients treated with and without
manual thrombus aspiration, in an academic, high-volume percutaneous coronary
intervention (PCI) center. Methods. A total of 433 consecutive patients who
underwent primary PCI in 2011-2012 were enrolled in the study. Patients were
not eligible for the study if they already suffered a myocardial infarction,
had been previously revascularized, received thrombolytics, presented with
cardiogenic shock, had significant valvular disease, atrial fibrillation or
had previously implanted pacemaker. Comprehensive echocardiogram was
performed within 48 hours. During follow-up patients? status was assessed by
an office visit or telephone interview. Results. Patients treated with
thrombus aspiration (TA+, n=216) had similar baseline characteristics as
those without thrombus aspiration (TA-, n=217). Groups had similar total
ischemic time (319 ? 276 vs. 333?372 min; p=0.665), but TA+ group had higher
maximum values of troponin I (39.5 ? 30.5 vs. 27.6 ? 26.9 ng/ml; p<0.001).
The echocardiography revealed similar left ventricular volumes and systolic
function, but TA+ group had significantly higher incidence of E/e?>15, as a
marker of severe diastolic dysfunction (TA+ 23.1% vs. TA- 15.2%; p=0.050).
During average follow-up of 14?}5 months, major adverse cardiac/ cerebral
events occurred at the similar rate (log rank p=0.867). Conclusion. Thrombus
aspiration is associated with a greater incidence of severe diastolic
dysfunction in unselected STEMI patients treated with primary PCI, but it
doesn?t influence the incidence of major adverse cardiovascular events.
Echocardiographic Evaluation of Left Ventricular Diastolic Function after Percutaneous Coronary Intervention in Patients with Acute STEMI
