Sanjit S Jolly, John A Cairns, Salim Yusuf, Brandi Meeks, Janice Pogue, Michael J Rokoss, Sasko Kedev, Lehana Thabane, Goran Stankovic, Raul Moreno, Anthony Gershlick, Saqib Chowdhary, Shahar Lavi, Kari Niemelä, Philippe Gabriel Steg, Ivo Bernat, Yawei Xu, Warren J Cantor, Christopher B Overgaard, Christoph K Naber, Asim N Cheema, Robert C Welsh, Olivier F Bertrand, Alvaro Avezum, Ravinay Bhindi, Samir Pancholy, Sunil V Rao, Madhu K Natarajan, Jurriën M Ten Berg, Olga Shestakovska, Peggy Gao, Petr Widimsky, Vladimír Džavík
Background During primary percutaneous coronary intervention (PCI), manual thrombectomy may reduce distal embolization and thus improve microvascular perfusion. Small trials have suggested that thrombectomy improves surrogate and clinical outcomes, but a larger trial has reported conflicting results. Methods We randomly assigned 10,732 patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary PCI to a strategy of routine upfront manual thrombectomy versus PCI alone. The primary outcome was a composite of death from cardiovascular causes, recurrent myocardial infarction, cardiogenic shock, or New York Heart Association (NYHA) class IV heart failure within 180 days...
April 9, 2015: New England Journal of Medicine