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EARLY-MYO

Study design

  • This study evaluated the safety and efficacy of a pharmaco-invasive strategy (using half-dose alteplase) vs. routine PPCI in patients (18-75 years) with STEMI, with an expected PCI-related delay, presenting within 6 hours of symptom onset.
  • A total of 344 STEMI patients were enrolled from 7 Chinese centres between January 2014 and September 2016 and randomised 1:1.
  • For 328 patients, primary endpoint data are available (pharmaco-invasive group, n=161; PPCI group, n=167).
  • Complete epicardial reperfusion (defined as TFG* 3) and myocardial reperfusion (defined as TMPG§ 3) after PCI, and complete (≥70%) reperfusion 60 minutes after PCI were the primary endpoint criteria.

 *TFG: thrombolysis in myocardial infarction flow grade; §TMPG: thrombolysis in myocardial infarction myocardial perfusion grade

Results

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Conclusion

In STEMI patients presenting within 6 hours of symptom onset and with an expected PCI-related delay, a pharmaco-invasive strategy provided a more complete reperfusion (epicardial and myocardial) than PPCI.

Reference:

  1. Pu J, et al. Efficacy and safety of a pharmaco-invasive strategy with half-dose alteplase versus primary angioplasty in ST-segment-elevation myocardial infarction. EARLY-MYO trial (Early Routine Catheterization After Alteplase Fibrinolysis Versus Primary PCI in Acute ST-Segment–Elevation Myocardial Infarction). Circulation 2017;136:00-00. DOI:10.1161/CIRCULATIONAHA.117.030582.