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ISCHAEMIC HEART DISEASE
No studies to date have specifically addressed whether primary PCI is the most beneficial strategy in the patient presenting more than 12 hours from the onset of an ST elevation myocardial infarction (STEMI). In the BRAVE-2 trial, 365 patients presenting between 12–48 hours after the start of symptoms were randomised to immediate invasive treatment (stenting with abciximab) or a conventional conservative treatment strategy. The primary end point of left ventricular infarct size (as measured by a single photon emission computed tomography (SPECT) study with technetium sestamibi) was found to be significantly smaller in patients assigned to the invasive group (median 8% v 13%). The mean difference in final left ventricular infarct size was –6.8% smaller in the invasive group. No significant differences between the two treatment groups were found on comparing the secondary end point, a composite of death, recurrent myocardial infarction (MI), or stroke at 30 days.
Schomig A,
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