- Question
- Does routine manual thrombus aspiration before primary PCI reduce mortality in patients with ST-segment elevation myocardial infarction?
- Design
- Multicenter, prospective, randomized, controlled, open-label trial of 7244 patients. Enrollment was based on the Swedish SCAAR registry and outcomes were ascertained through national registries; no patients were lost to follow-up.
- Population
- Patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention.
- Intervention
- Manual intracoronary thrombus aspiration followed by PCI.
- Control
- PCI alone, without prior thrombus aspiration.
- Primary outcome
- All-cause mortality at 30 days.
- Results
- Death at 30 days occurred in 2.8% (103 of 3621) with thrombus aspiration versus 3.0% (110 of 3623) with PCI alone (HR 0.94; 95% CI 0.72 to 1.22; P=0.63). Hospitalization for recurrent myocardial infarction was 0.5% versus 0.9% (HR 0.61; 95% CI 0.34 to 1.07; P=0.09).
- Safety
- There were no significant differences between groups in stroke or neurologic complications at discharge (P=0.87). Stent thrombosis occurred in 0.2% versus 0.5% (HR 0.47; 95% CI 0.20 to 1.02; P=0.06).
- Conclusion
- Routine thrombus aspiration before PCI did not reduce 30-day mortality compared with PCI alone in STEMI.
- Why it matters
- The trial challenged the routine use of thrombus aspiration during primary PCI, showing no mortality benefit in a pragmatic, registry-based design.
Card generated automatically with AI from the abstract of the original publication and the trial registry; every figure was checked against those sources. It may contain errors: verify the data at the source before using it for clinical decisions.
Generated on October 14, 2026