Hugelshofer S, et al. - In this retrospective study of patients enrolled in the Acute Myocardial Infarction in Switzerland Plus registry, researchers determined the impact of total ischemic time (TIT) on clinical outcomes in ST-elevation myocardial infarction (STEMI) patients undergoing manual thrombus aspiration (TA) during primary percutaneous coronary intervention (pPCI). They found that irrespective of TIT, there was no link between manual TA and lower risk-adjusted in-hospital all-cause mortality vs PCI-alone. However, manual TA was related to a significantly greater risk of major adverse cardiac events (MACE). They also observed that patients with prolonged TIT had higher risk-adjusted MACE rates vs manual TA vs PCI-alone.