Evidence map›Paper›PMID 33865512›Full record

ArticleIndian heart journal

Aspiration thrombectomy in ST-Elevation myocardial infarction: Further insights from a network meta-analysis of randomized trials.

Rama Dilip Gajulapalli, Arun Kanmanthareddy, Kathir Balakumaran, Hwanhee Hong, Shari Bolen, Meera Kondapaneni, Tilak K R Pasala

Open access · goldAbstract readNetwork Meta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Article in Indian heart journal. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact, top 100% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 2 citations in OpenAlex.

  1. Review
  2. Increased Thrombogenicity is Associated With Coronary Microvascular Dysfunction in Patients With STEMI-A Proof-of-Concept Study.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2025
    Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 5 institutions in 1 country.

Rama Dilip GajulapalliDepartment of Hospital Medicine, Cleveland Clinic, Cleveland, OH, USA. Electronic address: Gajular@ccf.org.
Arun KanmanthareddyDivision of Cardiology, Creighton University School of Medicine, Omaha, NE, USA.
Kathir BalakumaranThe Heart and Vascular Center, Case Western Reserve University/MetroHealth, Cleveland, OH, USA.
Hwanhee HongDepartment of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Shari BolenCenter for Health Care Research and Policy, MetroHealth/Case Western Reserve University School of Medicine, Cleveland, OH, USA.
Meera KondapaneniThe Heart and Vascular Center, Case Western Reserve University/MetroHealth, Cleveland, OH, USA.
Tilak K R PasalaHeart and Vascular Center, Hackensack University Medical Center, Hackensack, NJ, USA.
MetroHealth Medical Center · USCleveland Clinic · USCreighton University · USHackensack University Medical Center · USJohns Hopkins University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe initial enthusiasm for thrombectomy during percutaneous coronary intervention (PCI) of ST-elevation myocardial infarction (STEMI) patients has given way to restraint. There has been some limited interest whether it is beneficial in a few selected subgroups. Hence, we performed a network meta-analysis to compare conventional PCI (cPCI), Aspiration or manual thrombectomy (AT) and Mechanical thrombectomy (McT) for clarification.

methodsElectronic databases were searched for randomized studies that compared AT, McT, or cPCI. A network meta-analysis was performed and odd's ratio (OR) with 95% confidence intervals was generated for major adverse cardiac events (MACE), mortality, myocardial infarction (MI), target vessel revascularization (TVR), stent thrombosis (ST), stroke, left ventricular ejection fraction (LVEF), myocardial blush grade (MBG) and ST segment resolution (STR).

resultsA total of 43 randomized trials (n = 26,682) were included. The risk of MACE (OR 0.86 95% CI 0.73-1.00), Mortality (OR 0.85 95% CI 0.73-0.99), MI (OR 0.65, 95% CI: 0.44-0.95) and TVR (OR 0.86, 95% CI: 0.74-1.00) were lower with AT compared to cPCI. The risk of ST and stroke was no different with the use of adjunctive AT. MBG, STR, and LVEF improved with the use of AT while the infarct size was no different in the two groups.

conclusionsOur comprehensive network meta-analysis suggests conflicting outcomes with AT. While Mortality, MACE, MI seem better, there is a suggestion that, Stroke and ST might be worse. Whether AT can still be pursued in any select cases should be further scrutinized.

Indexed as

Percutaneous Coronary InterventionST Elevation Myocardial InfarctionHumansRandomized Controlled Trials as TopicStroke VolumeThrombectomyTreatment OutcomeVentricular Function, LeftAspiration thrombectomyMechanical thrombectomyNetwork meta-analysisPercutaneous coronary interventionST-Segment elevation myocardial infarction

Identifiers

PMID33865512
PMCPMC8065356
OpenAlexW3118546464

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.