Left Ventricular Unloading in Anterior ST-Segment Elevation Myocardial Infarction Without Shock: The ST-Segment Elevation Myocardial Infarction Door to Unload Randomized Controlled Trial
Primary result · IS/LVMResult — go to the resultMean difference −1.1% 95% CI −4.2 to 2.0Authors' conclusion
Combination of a TV-mAFP plus delayed PCI did not reduce infarct size in patients with anterior STEMI without cardiogenic shock compared with PCI alone.
Study context
- Population
- Adults 18–85 years with acute anterior STEMI without cardiogenic shock, no prior MI, presenting within 1–6 h of symptom onset
- Participants
- 527 adults
- Comparison
- Left ventricular (LV) unloading with transvalvular microaxial flow pump (TV-mAFP) + 30-min delay before percutaneous coronary intervention (PCI) vs PCI alone
- Treatmentn = 262
- Controln = 265reference
- Primary endpoint
- Infarct size normalized to LV mass (IS/LVM) by cardiac MRI
- Follow-up
- 3 to 5 days after PCI
Methodological detailsopen-label, multicentre (55 hospitals), Total ischemic time was longer in the treatment arm
- Open-label
- Multicentre (55 hospitals)
- Total ischemic time was longer in the treatment arm
Primary result
IS/LVM
Mean difference
−1.1%
95% CI −4.2 to 2.0
P = 0.50
By group
Treatment vs Control
mean difference −1.1% (95% CI −4.2 to 2.0); P = 0.50
As reported in the abstract
Safety
Major bleeding or vascular complications · 30-day follow-up
- More frequent in treatment group vs prespecified performance goal or control group
Original publication
Left Ventricular Unloading in Anterior ST-Segment Elevation Myocardial Infarction Without Shock: The ST-Segment Elevation Myocardial Infarction Door to Unload Randomized Controlled Trial. J Am Coll Cardiol. Published 28 March 2026. doi:10.
Summarised from the published abstract; every number is checked against it