Aspiration Thrombectomy in PCI for STEMI On Decline

The use of aspiration thrombectomy (AT) during percutaneous coronary intervention (PCI) has declined in recent years, according to a new retrospective analysis.  

The authors, publishing online in JAMA Cardiology, preformed a retrospective cohort study of 683,584 patients who underwent PCI for ST-elevation myocardial infarction (STEMI) from the National Cardiovascular Data Registry (NCDR) Cath PCI Registry from 2009 to 2016. The primary study outcomes were in-hospital stroke and death, with an array of secondary outcomes that included heart failure, stroke, all-cause rehospitalization, and death through 180 days of follow-up. Most of the patients in the study sample were male (71.6%) and white (87.2%).  

According to the analysis results, AT use increased between 2009 and 2011, then declined through 2016. During the period where the use of AT increased, it attained a peak use of 13.8%. It then dropped by 9%, reaching 4.7% by mid-2016. The overall use of AT was 10.8%. The researchers reported that the use of AT did not have an association with in-hospital death but was associated with a small increase in in-hospital (P=0.03). No differences were reported in cumulative events at 180 days. 

“Aspiration thrombectomy use is declining nationwide, with trends in use corresponding with evolving trial data,” the authors wrote. “There was no clinical benefit of selective aspiration thrombectomy use during primary percutaneous coronary intervention for STEMI.” 

The added that “these data demonstrate an association of physician practice patterns with evolving trial data and support the use of registry data for evaluating postapproval physician behavior.” 

Source: JAMA Cardiology