According to the study abstract, the Door to Unload in ST-segment elevation myocardial infarction (STEMI) safety and feasibility study represents the first human experience of mechanically unloading the LV and delaying reperfusion (primary unloading) in acute MI. The multicenter, prospective, randomized pilot trial assigned 50 patients with STEMI referred for primary percutaneous coronary intervention (PCI) within 1- 6 hours of symptom onset to primary unloading with an Impella CP followed by either immediate reperfusion or 30 minutes of unloading prior to reperfusion (U-DR). The primary outcome was a composite of major adverse cardiovascular and cerebrovascular events (MACCE).
All patients assigned to the U-DR group completed 30 minutes of LV unloading prior to PCI. Mean door-to-balloon time was 72 mins for U-IR compared to 97 mins for U-DR. Overall MACCE was 10% and did not differ between study groups.
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