Routine manual thrombus aspiration before primary PCI,
does it really help with Reduced 30-day all-cause mortality in STEMI?
research showsGrade D. TASTE found 30-day death in 103/3621 (2.8%) versus 110/3623 (3.0%), HR 0.94 (95% CI 0.72 to 1.22), absolute difference -0.2 points. The interval retains tails for benefit and harm.
ads claimRemoving visible thrombus does not by itself establish improved survival.
Useful facts when choosing a product
- The absolute mortality difference was -0.2 points.
- Stroke or neurologic complications were 0.5% in both groups.
What the research actually shows
Axis 6 B0 evidence ① Allocation concealment: "Patients were randomly assigned online" through SWEDEHEART before PCI ② Blinding: open-label procedure, but the primary endpoint was all-cause death from national registries ③ Analysis and missingness: "All analyses were performed according to the intention-to-treat principle" with complete registry vital-status follow-up ④ Prespecified primary endpoint: "The primary end point was all-cause mortality at 30 days" - consistent with NCT01093404 Funding consisted of unrestricted research grants from the Swedish Research Council, the Swedish Association of Local Authorities and Regions, Terumo Medical Corporation, Medtronic, and Vascular Solutions. Verdict 1791 shows the benefit of primary PCI itself; TASTE shows that routinely adding aspiration is null.
Why this is classified as D (34)
One large public registry-based hard-outcome null RCT gives D, 34.
Counterpoint. The lower CI bound retains mortality benefit.
Rejudgment record. Primary-source cross-check — Large public registry-based randomized trial with null 30-day mortality
| Endpoint | H | Hard endpoint - actual events such as death |
| Replication | R1 | Single confirmatory trial |
| Independence | I1 | Mixed funding sources |
| Effect size | E0 | Null |
| Precision | C0 | The confidence interval leaves room for benefit |
The scoring table and the verdict agree (D).
Cross-check — AI research and Codex final gate
Evidence Table
| Study | Design | Sample | Funding | Endpoint | Result | Weight |
|---|---|---|---|---|---|---|
| TASTE | Registry-based multicenter open-label randomized trial | 7,244 | Unrestricted research grants from the Swedish Research Council, the Swedish Association of Local Authorities and Regions, Terumo Medical Corporation, Medtronic, and Vascular Solutions | All-cause death at 30 days | 2.8% vs 3.0%; HR 0.94 (95% CI 0.72 to 1.22); absolute difference -0.2 points | Large pivotal hard-outcome trial |
Receipt — 2 References
All 2 cited sources were verified for existence at the original page (as of 2026-08-26).
Final verification and publication gate: Codex · Verification cutoff: 2026-08-26 · Corrections: none
Cite this verdict
[Chamgap] No Benefit of Routine Thrombus Aspiration for 30-Day Mortality in Primary PCI for ST-Elevation Myocardial Infarction — Evidence Grade D·34. 2 cited sources checked. Source: https://chamgap.com/en/verdicts/heart/routine-thrombus-aspiration-primary-pci-stemi-thirty-day-mortality/ · CC BY 4.0CC BY 4.0 — free to use with attribution; do not distort grades, numbers, or verdict meaning.
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