Study Type
Interventional - Device
completed
Two large trials, prior to the TOTAL study, had reported contradictory results at one year after thrombus aspiration in ST elevation myocardial infarction (STEMI). In a one-year follow-up of the largest randomised trial of thrombus aspiration, we aimed to clarify the longer-term benefits, to help guide clinical practice.
The objective of the TOTAL study was to determine if aspiration thrombectomy can reduce the rate of cardiovascular death, re-infarction, cardiogenic shock or new or worsening NYHA Class IV heart failure up to 180 days, in patients with STEMI undergoing primary PCI.
TOTAL was a randomized, unblinded treatment with outcomes adjudicated by assessors who will be blinded to the treatment arm.
We found that routine thrombus aspiration during PCI for STEMI did not reduce longer-term clinical outcomes and might be associated with an increase in stroke. As a result, thrombus aspiration can no longer be recommended as a routine strategy in STEMI.
Study Design
Randomized trial
NO. of Countries
20
NO. of Sites
87
NO. of Participants
10732
Study Period
2010 - 2015
Sponsor
PHRI
VIDEO: Sanjit Jolly on TOTAL study, at ACC 2016
Sanjit Jolly
Scientist
Sanjit Jolly
Scientist
Sanjit Jolly is an interventional cardiologist at Hamilton Health Sciences and associate professor at McMaster University. He has formal training in clinical trials with a M.Sc. in Health Research Methodology from McMaster. He was the principal investigator of the RIVAL trial, a randomized trial of 7021 patients comparing radial and femoral access for coronary intervention. He is also the principal investigator trial of the ongoing TOTAL trial, an international randomized trial (N=10,700) of thrombectomy during primary PCI.
