Prehospital Pulse-Dose Glucocorticoid in ST-Segment Elevation Myocardial Infarction: The PULSE-MI Randomized Clinical Trial
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
Methodological detailsinvestigator-initiated, blinded, placebo-controlled, 1:1
- Investigator-initiated
- Blinded
- Placebo-controlled
- 1:1
Primary result
As reported in the abstract
Final infarct size
P = 0.24
Secondary outcomes
| Outcome | Estimate | |
|---|---|---|
| Acute infarct size | OR 0.78 (95% CI 0.61–1.00) | |
| Microvascular obstruction | relative risk ratio 0.83 (95% CI 0.71–0.99) | |
| 0.512Ratio (log scale) |
| Outcome | Mean difference (%) (95% CI) | |
|---|---|---|
| Acute LVEF | 4.44 (2.01%–6.87%) | |
| −50510Difference, % (linear scale) |
Other secondary outcomes
- Similar in both groups
Original publication
Prehospital Pulse-Dose Glucocorticoid in ST-Segment Elevation Myocardial Infarction: The PULSE-MI Randomized Clinical Trial. JAMA Cardiol. Published 1 October 2024. doi:10.
Summarised from the published abstract; every number is checked against it