Incidence, Clinical Characteristics and Prognosis of Patients With ST-segment Elevation Myocardial Infarction (STEMI) and Spontaneous Coronary Reperfusion in the Modern Antithrombotic Strategy Area

University Hospital Center (CHU)

Status: Completed

Conditions: Coronary Syndrome

Study type: Observational

Funder types: Other

Identifiers

NCT04881552

RECHMPL21_0232

Details and patient eligibility

About

The rapid and complete restoration of coronary flow is a key issue in the management of STEMI. Primary percutaneous coronary intervention (PCI) is the preferred reperfusion strategy associated with antithrombotic drugs.

In daily practice, it is not rare that some patients may achieve reopening of the culprit artery without undergoing any mechanical reperfusion therapy, which is called " spontaneous reperfusion ". The latter is associated with improved outcomes in several studies but none of these studies were done in the modern antithrombotic strategy area including new P2Y12 inhibitors. The aim of this study is to report the incidence, characteristics and outcomes of consecutive patients with STEMI admitted for coronary angiography with angiographic clinical evidence of spontaneous reperfusion in the modern medical antithrombotic strategy associated with primary PCI.

Enrollment: 302 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Older than 18 years old.
• patients with ongoing (within 12 hours after onset of symptoms) STEMI admitted for coronary angiography and receiving preloading dose of aspirin, heparin and P2Y12 inhibitor

Exclusion criteria

• Patients with thrombolysis treatment before angiography
• Patients with cardiac arrest without ST-segment elevation on ECG after resuscitation
• Patients with myocardial infarction outside of acute phase (pain lasting more 12 hours)
• Patients with mental disease
• Patients not living in France

Trial design

302 participants in 2 patient groups

Group 1

Description:

non-spontaneous reperfusion group at initial emergency coronary angiography (TIMI flow grade 0-II)

Arm 2

Description:

spontaneous reperfusion group at initial emergency coronary angiography (TIMI flow grade III)