Mahmoud KD, et al. - In a study population comprising ST-segment elevation myocardial infarction (STEMI) patients undergoing percutaneous coronary intervention (PCI), researchers investigated the effect of direct stenting (DS) on clinical outcome and myocardial reperfusion and its interaction with thrombus aspiration. They merged patient-level data from the three largest randomized trials on routine manual thrombus aspiration vs PCI only, and created a 1:1 propensity matched population to compare DS and conventional stenting. In patients randomized to thrombus aspiration, higher direct stenting rates were seen vs PCI only. Between DS and conventional stenting, no significant difference was noted in regard to clinical outcomes and myocardial reperfusion measures. No interaction with thrombus aspiration was visible.