Higuchi S, et al. - Whether the clinical impact of thrombus aspiration (TA) depends on culprit lesions in patients with ST-segment elevation myocardial infarction (STEMI) was investigated using data from the Tokyo Coronary Care Unit Network Registry. In univariate logistic regression analysis, TA was shown to be related to a lower in-hospital mortality rate, however, no significant difference was seen after multivariate logistic regression analysis. Overall, TA was not recommended in Japanese patients with STEMI, as no prognostic benefit of TA on in-hospital mortality was found in a large Japanese cohort. Moreover, marginally significant and limited effect of TA on the left circumflex lesions was seen.