Deferred Stenting in Patients With Anterior Wall STEMI (INNOVATIONCORE)
Acute Myocardial Infarction With ST Elevation, Anterior Wall Myocardial Infarction
About this trial
This is an interventional treatment trial for Acute Myocardial Infarction With ST Elevation focused on measuring STEMI, Deferred stenting, Anterior wall myocardial infarction
Eligibility Criteria
Inclusion Criteria:
- Typical ischemic chest pain lasting more than 30 minutes
- New ST elevation at the J point in two contiguous leads with the cut-points: ≥0.1 mV in all leads other than leads V2-V3 where the following cut-points apply: 0.2 ≥mV in men ≥40 years; ≥0.25 mV in men <40 years, or ≥0.15 mV in women27 or new left bundle branch block28.
- Symptom onset of chest pain within 6 hours
- If left anterior descending artery is culprit lesion on coronary angiography (Ostium to mid lesion). However, if the right coronary artery is hypoplastic and the distal portion of the left anterior descending artery feeds to the area of the posterior lower coronary artery (PDA), culprit lesion of the distal part of left anterior descending artery can also be included in the study.
- If TIMI blood flow before intervention is 0, 1 or 2
- If TIMI 3 blood flow was secured before coronary stenting by intracoronary abciximab injection, manual thrombus aspiration and balloon dilatation
- Patients who wrote the informed consent: The subject should be able to receive informations of treatment, risks, effects and other therapeutic modalities regarding staged percutaneous coronary intervention (PCI) at least verbally, and investigators should be provided written informed consent from a subject or a legally recognized representative prior to giving any treatment related to the study.
Exclusion Criteria:
- If there is a previous history of myocardial infarction or coronary artery bypass surgery
- Cardiogenic shock
- Rescue PCI after thrombolytic therapy
- If the life expectancy of the accompanying disease is expected to be less than one year or the patient is not cooperating with the protocol.
- In cases where the left main lesion is an infarction related artery (If the left main lesion is a simple left main branch lesion rather than an infarction related vessel, it is included in the study)
- STEMI due to Stent thrombosis
- A major dissection (Type C to F) occurred during the procedure including balloon dilatation for securing TIMI blood flow and the risk of acute closure at the time of staged stenting was expected
Sites / Locations
- Korea University Anam HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Placebo Comparator
Active Comparator
Immediate stenting
Deferred stenting
Within enrolled patients who agreed to participate in the study, signed informed consent and being satisfied with inclusion and exclusion criteria, stent implantation is done on the initial procedure in immediate stenting group.
Within enrolled patients who agreed to participate in the study, signed informed consent and being satisfied with inclusion and exclusion criteria, only TIMI Ⅲ flow achievement is done on the initial procedure and stent implantation is deferred for 3-7 days in the deferred stenting group.