TACTIC Coronary Thrombus Aspiration With Cath Rx In Anterior Myocardial Infarction: A Randomized Control Trial.

Exclusion Criteria

• •1. Unable to give Informed consent.
• •2. Life expectancy \< 1 year.
• •3. Contraindication to PCI
• •4. STEMI due to stent thrombosis
• •5. Spontaneous coronary aretery dissection
• •6. Patient undergone any kind of maneuvers to restore flow before randomization
• •7. Unwitnessed cardiac arrest OR ≥30 minutes of cardiopulmonary resuscitation (CPR) prior to enrolment OR any cardiac arrest with impairment in mental status, cognition or any global or focal neurological deficit
• •8. New onset of stroke symptoms and NIHSS \>2, prior to index procedure
• •9. Known intolerance to aspirin, clopidogrel, ticagrelor, heparin, contrast media.
• •10. Active severe bleeding
• •11. Severe hepatic/kidney impairment
• •12. Administration of fibrinolytic therapy within 24 hours prior to enrolment
• •13. Cardiogenic shock defined as systemic hypotension (systolic BP \<90 mmHg or the need for inotropes/pressors to maintain a systolic BP \>90 mmHg), plus one (1) of the following: any requirement for pressors / inotropes prior to arrival at the catheterization laboratory, clinical evidence of end-organ hypoperfusion, or use of IABP or any other mechanical circulatory support device
• •14. Inferior STEMI or suspected right ventricular failure
• •15. Severe valvulopathy
• •16. Acute cardiac mechanical complication: LV-free wall rupture OR interventricular septum rupture OR acute mitral regurgitation
• •Medical Conditions \& History:
• •1. Suspected or known pregnancy
• •2. Suspected systemic active infection
• •3. History or known hepatic insufficiency prior to catheterization
• •4. Undergoing a renal replacement therapy
• •5. Chronic obstructive pulmonary disease (COPD) with home oxygen therapy or on chronic steroid therapy
• •6. Contraindication to perform MRI or use gadolinium \[creatinine clearance (CrCl) \<30 mL/min, non-compatible implant, claustrophobia\]
• •Cardiovascular history
• •1. Known or evidence of prior MI, including pathologic Q-waves in non-anterior leads
• •2. Prior coronary artery bypass graft surgery (CABG) or LAD PCI
• •3. History of heart failure (documented history of EF \<40% or documented hospitalization for HF within 1 year prior to screening
• •4. Prior aortic valve surgery or TAVR
• •5. Left bundle branch block (new or old)
• •6. History of stroke/TIA within 3 months prior to screening