"Early intervention does work, and it seems to improve the prognosis."
The TRANSFER AMI trial, published in this week's New England Journal of Medicine, revealed that STEMI patients who received PCI treatment within six hours of fibrinolysis experienced significantly fewer ischemic complications compared to the standard treatment. These results could greatly impact the management of acute MI patients, especially in the decision to transfer these patients to a different hospital.
In an accompanying NEJM editorial, Dr. Freek W.A. Verheugt wrote that PCI at 17 hours seemed to be as good as at two hours. However, waiting "longer than 24 hours can be disadvantageous given the increasing risk of reocclusion of the infarct-related artery," he said.
In other interventional clincial news, PCI using Cordis' Cypher drug-eluting stent (DES) is not inferior to minimally invasive direct CABG at one-year follow up with respect to major adverse cardiac events in patients with isolated proximal left anterior descending disease, according to a study in JACC. While these results seem promising for treating this precarious patient population with PCI, the authors noted that their study of 130 patients was not powered to assess whether PCI was superior to minimally invasive direct CABG.
On the interventional front, Abbott Vascular obtained the CE Mark for its new Xience Prime DES for the treatment of coronary artery disease. The company also launched its U.S. clincal trial for investigational Xience Prime, the results of which will be used to support its regulatory filing with the FDA.
With the 2009 TCT meeting still a few months away, the interventional realm will continue to produce data for the management of heart attack patients that are sure to be topics of discussion at the show.
On these topics, or any others, please feel free to contact me.