Revascularization Strategies for STEMI; The CMR Endpoint Study (ASSIST-CMR)

Unity Health Toronto

Status

Unknown

Conditions

Acute Myocardial Infarction

Treatments

Procedure: SS-PCI

Procedure: IRA-PCI

Study type

Interventional

Funder types

Other

Identifiers

NCT01818960

AC-103

Details and patient eligibility

About

Revascularization strategies for ST elevation myocardial infarction (STEMI) study (ASSIST-CMR) will compare the effects of two revascularization strategies [same sitting multivessel primary PCI (SS-PCI) and culprit vessel only primary PCI (IRA-PCI)] on myocardial infarct size (MIS) as determined by cardiac magnetic resonance (CMR) imaging in patients presenting with STEMI and multivessel disease (MVD).

Enrollment

250 estimated patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

High risk ST elevation myocardial infarction evidenced by: ≥2 mm ST elevation in 2 anterior or lateral leads; or ≥2 mm ST elevation in 2 inferior coupled with ST depression in 2 contiguous anterior leads for a total ST deviation of ≥8 mm; or New left bundle branch block with at least 1 mm concordant ST elevation.
Multivessel CAD as evidenced by ≥1 significant (≥70% by visual assessment or FFR<0.80 for 50-70% stenosis) stenosis in non-IRA.
Successful IRA-PCI with <10% residual angiographic stenosis and TIMI III flow.
Written informed consent.

Exclusion criteria

Age ≤ 18 years.
Prior coronary artery bypass graft (CABG) surgery.
Administration of thrombolytic therapy.
Non-IRA stenosis is a chronic total occlusion or located in left main artery.
Hemodynamic instability evidenced by BP<90 mmHg, Killip class ≥2, need for inotropes/vasopressors.
Known renal insufficiency (estimated GFR < 50ml/min).
Contraindication to CMR.