Coronary disease & ACSRandomised controlled trial
Left Ventricular Unloading in Anterior ST-Segment Elevation Myocardial Infarction Without Shock
- Randomised controlled trial
- open-label
- multicentre (55 hospitals)
- Total ischemic time was longer in the treatment arm
Authors' 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
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. J Am Coll Cardiol. Published 28 March 2026. doi:10.1016/j.jacc.2026.03.071
Summarised from the published abstract; every number is checked against it