Outcomes after thrombus aspiration for ST elevation myocardial infarction: 1-year follow-up of the prospective randomised TOTAL trial
Lancet
; 387(10014): 127-135, 2016.
Article
in English
| Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP
| ID: biblio-1064586
Responsible library:
BR79.1
Localization: BR79.1
ABSTRACT
BackgroundTwo large trials have reported contradictory results at 1 year after thrombus aspiration in ST elevation myocardial infarction (STEMI). In a 1-year follow-up of the largest randomised trial of thrombus aspiration, we aimed to clarify the longer-term benefits, to help guide clinical practice.MethodsThe trial of routine aspiration ThrOmbecTomy with PCI versus PCI ALone in Patients with STEMI (TOTAL) was a prospective, randomised, investigator-initiated trial of routine manual thrombectomy versus percutaneous coronary intervention (PCI) alone in 10 732 patients with STEMI. Eligible adult patients (aged ≥18 years) from 87 hospitals in 20 countries were enrolled and randomly assigned (11) within 12 h of symptom onset to receive routine manual thrombectomy with PCI or PCI alone. Permuted block randomisation (with variable block size) was done by a 24 h computerised central system, and was stratified by centre. Participants and investigators were not masked to treatment assignment. The trial did not show a difference at 180 days in the primary outcome of cardiovascular death, myocardial infarction, cardiogenic shock, or heart failure. However, the results showed improvements in the surrogate outcomes of ST segment resolution and distal embolisation, but whether or not this finding would translate into a longer term benefit remained unclear...
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Collection:
National databases
/
Brazil
Database:
Sec. Est. Saúde SP
/
SESSP-IDPCPROD
Main subject:
Thrombosis
/
Thrombectomy
/
Percutaneous Coronary Intervention
Type of study:
Controlled clinical trial
/
Practice guideline
Language:
English
Journal:
Lancet
Year:
2016
Document type:
Article
Institution/Affiliation country:
CK Hui Heart Centre/CA
/
Central Manchester Foundation Trust/GB
/
Dante Pazzanese Institute of Cardiology/BR
/
Duke Clinical Research Institute/US
/
Heart Center, Tampere University Hospital/FI
/
Krajská Nemocnice Liberec/CZ
/
London Health Sciences Centre, Department of Medicine/CA
/
Mazankowski Alberta Heart Institute/CA
/
McMaster University and the Population Health Research Institute/CA
/
Northeast Clinical Trials Group/US