Myocardial Infarction Clinical Trial
Official title:
The Randomized Physiologic Assessment of Thrombus Aspiration in Patients With Acute ST-segment Elevation Myocardial Infarction Trial
The Physiologic Assessment of Thrombus Aspiration in ST-segment Elevation Myocardial Infarction (PATA-STEMI) trial is a single center, prospective, randomized trial with a planned inclusion of 128 patients with the first ST-segment elevation myocardial infarction (STEMI). Patients are, before coronary angiography, randomly assigned to thrombus aspiration using 6 or 7 French Eliminate aspiration catheter (Terumo Medical Supply, Japan) or to conventional primary percutaneous coronary intervention (PCI). The primary endpoint is index of microcirculatory resistance (IMR), measured in infarct-related artery, in thrombus aspiration compared to conventional PCI group.
Background and Objective Routine thrombus aspiration is superior to conventional primary PCI
in terms of improved myocardial perfusion in STEMI patients. However, myocardial perfusion
after thrombus aspiration has not been evaluated by a quantitative, invasive method.
Investigators intend to determine whether thrombus aspiration of the infarct-related artery
increases myocardial perfusion, as measured by IMR, compared to conventional primary PCI.
Study design PATA-STEMI is a single center, prospective, randomized trial with a planned
inclusion of 128 patients with the first STEMI. Patients are randomly assigned, before
coronary angiography, to thrombus aspiration using the 6 or 7 French Eliminate aspiration
catheter (Terumo Medical Supply, Japan) or to conventional primary PCI. The IMR will be
determined in infarct-related artery and non-infarct-related arteries without critical
stenosis to measure microcirculatory resistance. The primary endpoint is defined as IMR in
infarct-related artery in thrombus aspiration compared to conventional PCI group. Secondary
end points are myocardial perfusion grade and resolution of ST-segment elevation, infarct
size and left ventricle remodeling, as assessed by echocardiographic indices. Transthoracic
echocardiography will be conducted within 24 hours and at 4 months after the primary PCI.
Implications: If manual thrombus aspiration reduces microcirculatory resistance, indicating
improved myocardial perfusion, as compared to conventional PCI, it might become the
preferred strategy in patients with STEMI.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Outcomes Assessor), Primary Purpose: Treatment
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