Coronary disease & ACSRandomised controlled trial

Prehospital Pulse-Dose Glucocorticoid in ST-Segment Elevation Myocardial Infarction

JAMA CardiolPublished

  • Randomised controlled trial
  • investigator-initiated
  • blinded
  • placebo-controlled
  • 1:1

Authors' conclusion

In patients with STEMI, treatment with prehospital pulse-dose glucocorticoid did not reduce final infarct size after 3 months.

Study context

Population
Adults with STEMI and <12 h of acute chest pain, prehospital setting, Region Zealand and Capital Region of Denmark401 (76%) assessed for primary outcome
Participants
530 adults
Comparison
Prehospital IV methylprednisolone 250 mg vs placebo
  • Glucocorticoidn = 198
  • Placebon = 203reference
Primary endpoint
Final infarct size on cardiac magnetic resonance (CMR)
Follow-up
3 months

Primary result

As reported in the abstract

Final infarct size

P = 0.24

Secondary outcomes

OutcomeEstimate
Acute infarct sizeOR 0.78 (95% CI 0.61–1.00)
Microvascular obstructionrelative risk ratio 0.83 (95% CI 0.71–0.99)
Outcomemean difference (%) (95% CI)
Acute LVEF4.44 (2.01%–6.87%)

Other secondary outcomes

Similar in both groups

Original publication

Prehospital Pulse-Dose Glucocorticoid in ST-Segment Elevation Myocardial Infarction. JAMA Cardiol. Published 1 October 2024. doi:10.1001/jamacardio.2024.2298

Summarised from the published abstract; every number is checked against it