iCVCT 7. STEMI Trials
Monday, December 7th: 4:00 – 6.00 pm
ST-segment elevation myocardial infarction (STEMI) is a serious manifestation of coronary artery disease, with a high risk of morbidity and mortality. Early diagnosis and immediate reperfusion are critical to limit myocardial ischemia, infarct size, complications, and heart failure. Urgent primary percutaneous coronary intervention (PCI) is recommended, but strategies to extend the benefit of primary reperfusion are needed. Unloading of the left ventricle with newer left ventricular assist devices such as Impella and TandemHeart can increase cardiac output may improve clinical outcomes for patients after an AMI. Trials have demonstrated benefits on hemodynamic outcomes, but do these devices have a mortality benefit?
This session will be chaired by Dr. Cindy Grines, and Dr. Timothy Henry. Dr. Grines is the Chief Scientific Officer of the Northside Hospital Cardiovascular Institute in Atlanta, GA, USA, and President of the Society for Cardiovascular Angiography and Interventions. Dr. Henry is from the Carl and Edyth Lindner Center for Research and Education at The Christ Hospital, in Cincinnati, OH, USA.
Dr. Navin Kapur (Boston,USA), principal investigator on the DTU-STEMI trial (Door-To-Unload in STEMI) will discuss the role of infarct size as a surrogate in STEMI trials. The STEMI-DTU pilot trial demonstrated the safety and feasibility of primary unloading with Impella followed by delayed reperfusion in patients with STEMI. It showed that the infarct size was relatively independent of the area at risk. Hemodynamic support using an intra- aortic balloon pump (IABP) did not improve 30-day mortality compared with control in the IABP-SHOCK II trial; but how did Impella compare in the IMPRESS in Severe Shock trial? This session will provide an update on past, current, and future trials of devices in STEMI, from Michael Gibson (Boston, USA).
The session and the moderated multi-stake holders’ debate will include additional points of view from an expanded panel of interventional cardiologists, industry, and regulatory representatives.