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dc.contributor.authorFröbert, Ole
dc.contributor.authorLagerqvist, Bo
dc.contributor.authorOlivecrona, Göran K
dc.contributor.authorOmerovic, Elmir
dc.contributor.authorGudnason, Thorarinn
dc.contributor.authorMaeng, Michael
dc.contributor.authorAasa, Mikael
dc.contributor.authorAngerås, Oskar
dc.contributor.authorCalais, Fredrik
dc.contributor.authorDanielewicz, Mikael
dc.contributor.authorErlinge, David
dc.contributor.authorHellsten, Lars
dc.contributor.authorJensen, Ulf
dc.contributor.authorJohansson, Agneta C
dc.contributor.authorKåregren, Amra
dc.contributor.authorNilsson, Johan
dc.contributor.authorRobertson, Lotta
dc.contributor.authorSandhall, Lennart
dc.contributor.authorSjögren, Iwar
dc.contributor.authorOstlund, Ollie
dc.contributor.authorHarnek, Jan
dc.contributor.authorJames, Stefan K
dc.date.accessioned2014-02-19T14:49:36Z
dc.date.available2014-02-19T14:49:36Z
dc.date.issued2013-10-24
dc.date.submitted2013
dc.identifier.citationN. Engl. J. Med. 2013, 369 (17):1587-97en
dc.identifier.issn1533-4406
dc.identifier.pmid23991656
dc.identifier.doi10.1056/NEJMoa1308789
dc.identifier.urihttp://hdl.handle.net/2336/313107
dc.descriptionTo access publisher's full text version of this article. Please click on the hyperlink in Additional Links field.en
dc.description.abstractThe clinical effect of routine intracoronary thrombus aspiration before primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI) is uncertain. We aimed to evaluate whether thrombus aspiration reduces mortality.
dc.description.abstractWe conducted a multicenter, prospective, randomized, controlled, open-label clinical trial, with enrollment of patients from the national comprehensive Swedish Coronary Angiography and Angioplasty Registry (SCAAR) and end points evaluated through national registries. A total of 7244 patients with STEMI undergoing PCI were randomly assigned to manual thrombus aspiration followed by PCI or to PCI only. The primary end point was all-cause mortality at 30 days.
dc.description.abstractNo patients were lost to follow-up. Death from any cause occurred in 2.8% of the patients in the thrombus-aspiration group (103 of 3621), as compared with 3.0% in the PCI-only group (110 of 3623) (hazard ratio, 0.94; 95% confidence interval [CI], 0.72 to 1.22; P=0.63). The rates of hospitalization for recurrent myocardial infarction at 30 days were 0.5% and 0.9% in the two groups, respectively (hazard ratio, 0.61; 95% CI, 0.34 to 1.07; P=0.09), and the rates of stent thrombosis were 0.2% and 0.5%, respectively (hazard ratio, 0.47; 95% CI, 0.20 to 1.02; P=0.06). There were no significant differences between the groups with respect to the rate of stroke or neurologic complications at the time of discharge (P=0.87). The results were consistent across all major prespecified subgroups, including subgroups defined according to thrombus burden and coronary flow before PCI.
dc.description.abstractRoutine thrombus aspiration before PCI as compared with PCI alone did not reduce 30-day mortality among patients with STEMI. (Funded by the Swedish Research Council and others; ClinicalTrials.gov number, NCT01093404.).
dc.description.sponsorshipSwedish Research Council, Swedish Association of Local Authorities and Regions, Terumo Medical Corporation, Medtronic, Vascular Solutions, Swedish Heart-Lung Foundation/20100178/ B0010401 Biotronik, Stentys, Abbott Vascular, St. Jude Medical, Boston Scientific, EPS Vascular, Cardiac Dimensions, AstraZeneca, Edwards Lifesciences,en
dc.language.isoenen
dc.publisherMassachusetts Medical Societyen
dc.relation.urlhttp://dx.doi.org/10.1056/NEJMoa1308789en
dc.rightsArchived with thanks to The New England journal of medicineen
dc.subjectKransæðasjúkdómaren
dc.subjectHjartaaðgerðiren
dc.subject.meshAgeden
dc.subject.meshCombined Modality Therapyen
dc.subject.meshCoronary Thrombosisen
dc.subject.meshElectrocardiographyen
dc.subject.meshFemaleen
dc.subject.meshHumansen
dc.subject.meshMaleen
dc.subject.meshMiddle Ageden
dc.subject.meshMyocardial Infarctionen
dc.subject.meshPercutaneous Coronary Interventionen
dc.subject.meshProspective Studiesen
dc.subject.meshRecurrenceen
dc.subject.meshSuctionen
dc.subject.meshThrombectomyen
dc.subject.meshTime-to-Treatmenten
dc.titleThrombus aspiration during ST-segment elevation myocardial infarction.en
dc.typeArticleen
dc.contributor.departmentOrebro Univ Hosp, Dept Cardiol, S-70185 Orebro, Sweden, Uppsala Univ, Dept Med Sci, Uppsala, Sweden, Uppsala Univ, Uppsala Clin Res Ctr, Uppsala, Sweden, Univ Lund Hosp, Dept Cardiol, S-22185 Lund, Sweden, Sahlgrens Univ Hosp, Dept Cardiol, Gothenburg, Sweden, Soder Sjukhuset, Karolinska Inst, Dept Cardiol, Stockholm, Sweden, Karolinska Univ Hosp, Dept Med, Cardiol Unit, Stockholm, Sweden, Karlstad Hosp, Dept Cardiol, Karlstad, Sweden, Gavle Cent Hosp, Dept Cardiol, S-80187 Gavle, Sweden, Sunderby Hosp, PCI Unit, Sunderby, Sweden, Vasteras Hosp, Dept Cardiol, Vasteras, Sweden, Umea Univ, Dept Cardiol, Ctr Heart, Umea, Sweden, Boras Hosp, Dept Cardiol, Boras, Sweden, Helsingborg Hosp, Dept Radiol, Helsingborg, Sweden, Falun Cent Hosp, Dept Cardiol, Falun, Sweden, Landspitali Univ Hosp Iceland, Dept Cardiol, Reykjavik, Iceland, Landspitali Univ Hosp Iceland, Cardiovasc Res Ctr, Reykjavik, Iceland, Aarhus Univ Hosp, Dept Cardiol, DK-8000 Aarhus, Denmarken
dc.identifier.journalNew England journal of medicineen
dc.rights.accessLandspitali Access - LSH-aðganguren
html.description.abstractThe clinical effect of routine intracoronary thrombus aspiration before primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI) is uncertain. We aimed to evaluate whether thrombus aspiration reduces mortality.
html.description.abstractWe conducted a multicenter, prospective, randomized, controlled, open-label clinical trial, with enrollment of patients from the national comprehensive Swedish Coronary Angiography and Angioplasty Registry (SCAAR) and end points evaluated through national registries. A total of 7244 patients with STEMI undergoing PCI were randomly assigned to manual thrombus aspiration followed by PCI or to PCI only. The primary end point was all-cause mortality at 30 days.
html.description.abstractNo patients were lost to follow-up. Death from any cause occurred in 2.8% of the patients in the thrombus-aspiration group (103 of 3621), as compared with 3.0% in the PCI-only group (110 of 3623) (hazard ratio, 0.94; 95% confidence interval [CI], 0.72 to 1.22; P=0.63). The rates of hospitalization for recurrent myocardial infarction at 30 days were 0.5% and 0.9% in the two groups, respectively (hazard ratio, 0.61; 95% CI, 0.34 to 1.07; P=0.09), and the rates of stent thrombosis were 0.2% and 0.5%, respectively (hazard ratio, 0.47; 95% CI, 0.20 to 1.02; P=0.06). There were no significant differences between the groups with respect to the rate of stroke or neurologic complications at the time of discharge (P=0.87). The results were consistent across all major prespecified subgroups, including subgroups defined according to thrombus burden and coronary flow before PCI.
html.description.abstractRoutine thrombus aspiration before PCI as compared with PCI alone did not reduce 30-day mortality among patients with STEMI. (Funded by the Swedish Research Council and others; ClinicalTrials.gov number, NCT01093404.).


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