While the study did not meet its primary endpoint, and was not powered to draw significant conclusions on clinical events, Dr Patel says the results nevertheless offer an insight into the treatment of STEMI patients. “The most striking observation is the excellent overall outcome for the highest risk patients within the context of this trial,” he says. “The IABC group had less than 5% mortality, and it’s difficult to improve that. We’ve become very good at treating AMI patients.” In the USA acute mortality risk in AMI is between 6% and 15%; one-year mortality is estimated at 38% for women and 25% for men.
Dr Patel adds that 15 of the patients in the SOC group crossed over to receive IABC, and five patients crossed over prior to PCI and ten patients after PCI. “While this trial shows that the routine use of IABC cannot be recommended in STEMI, physicians should be vigilant about identifying those patients who are at risk for rapid deterioration and may benefit from counterpulsation,” he says.
Doctor Patel, Manesh (Durham, USA)
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Notes to editor
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Hot Line III – Acute coronary syndromes
CRISP AMI: A multi-center, randomized, controlled study of mechanical left ventricular unloading with Counterpulsation to Reduce Infarct size pre-PCI for Acute Myocardial Infarction: rationale and design of the CRISP AMI trial
Edited by the ESC from material supplied by the investigator himself/herself, this press release does not necessarily reflect the opinion of the European Society of Cardiology. The content of the press release has been approved by the investigator.