TASTE: Does Thrombus Aspiration Before PCI Reduce 30-Day Mortality in STEMI Patients?

"It does throw into question a lot of the data that we've been using from the TAPAS Study," said Benjamin Scirica, MD, FACC.
Routine thrombus aspiration before PCI in STEMI patients did not reduce 30-day mortality as compared with PCI alone, according to results from the TASTE Trial presented on Sept. 1 at the ESC Congress 2013 and simultaneously published in the New England Journal of Medicine.

The study randomly assigned a total of 7,244 STEMI patients undergoing PCI and enrolled in the Swedish Coronary Angiography and Angioplasty Registry to manual thrombus aspiration followed by PCI or to PCI only. Overall, mortality from any cause occurred in 2.8 percent of the thrombus aspiration group, compared with 3.0 percent in the PCI group.

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Hospitalization rates for recurrent myocardial infarction (MI) at 30 days were 0.5 percent for the thrombus aspiration group and 0.9 percent for the PCI group and the rates of stent thrombosis were 0.2 percent and 0.5 percent, respectively. According to the study authors, there were also no significant differences between the groups in terms of stroke and neurologic complications at discharge. Similarly, there were not significant differences in the length-of-stay in the hospital.

In a corresponding editorial, Robert Byrne, MB, BCh, PhD, and Adnan Kastrati, MD, write that "perhaps the key question in interpreting the results of the TASTE Trial is, how sure are we that we are not missing a clinically important effect?" They point out that the trial results do not entirely exclude the possibility of a potential benefit with thrombus aspiration and suggest that an updated analysis of outcomes at 12 months of follow-up "is imperative." However, they also note, that "for now, the hope that this simple, easy-to-use, intuitively attractive technology could save the lives of patients presenting with myocardial infarction remains an unmet aspiration."

Keywords: Registries, Myocardial Infarction, Stroke, Follow-Up Studies, Coronary Angiography, Thrombosis, Angioplasty, Taste, New England, Stents

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