Early and long-term outcome of elective stenting of the infarct-related artery in patients with viability in the infarct-area: Rationale and design of the Viability-guided Angioplasty after acute Myocardial Infarction-trial The VIReport as inadecuate




Early and long-term outcome of elective stenting of the infarct-related artery in patients with viability in the infarct-area: Rationale and design of the Viability-guided Angioplasty after acute Myocardial Infarction-trial The VI - Download this document for free, or read online. Document in PDF available to download.

Current Controlled Trials in Cardiovascular Medicine

, 5:11

First Online: 11 November 2004Received: 14 October 2004Accepted: 11 November 2004DOI: 10.1186-1468-6708-5-11

Cite this article as: van Loon, R.B., Veen, G., Kamp, O. et al. Trials 2004 5: 11. doi:10.1186-1468-6708-5-11

Abstract

BackgroundAlthough percutaneous coronary intervention PCI is becoming the standard therapy in ST-segment elevation myocardial infarction STEMI, to date most patients, even in developed countries, are reperfused with intravenous thrombolysis or do not receive a reperfusion therapy at all. In the post-lysis period these patients are at high risk for recurrent ischemic events. Early identification of these patients is mandatory as this subgroup could possibly benefit from an angioplasty of the infarct-related artery.

Since viability seems to be related to ischemic adverse events, we initiated a clinical trial to investigate the benefits of PCI with stenting of the infarct-related artery in patients with viability detected early after acute myocardial infarction.

MethodsThe VIAMI-study is designed as a prospective, multicenter, randomized, controlled clinical trial. Patients who are hospitalized with an acute myocardial infarction and who did not have primary or rescue PCI, undergo viability testing by low-dose dobutamine echocardiography LDDE within 3 days of admission. Consequently, patients with demonstrated viability are randomized to an invasive or conservative strategy. In the invasive strategy patients undergo coronary angiography with the intention to perform PCI with stenting of the infarct-related coronary artery and concomitant use of abciximab. In the conservative group an ischemia-guided approach is adopted standard optimal care.

The primary end point is the composite of death from any cause, reinfarction and unstable angina during a follow-up period of three years.

ConclusionThe primary objective of the VIAMI-trial is to demonstrate that angioplasty of the infarct-related coronary artery with stenting and concomitant use of abciximab results in a clinically important risk reduction of future cardiac events in patients with viability in the infarct-area, detected early after myocardial infarction.

Electronic supplementary materialThe online version of this article doi:10.1186-1468-6708-5-11 contains supplementary material, which is available to authorized users.





Author: Ramon B van Loon - Gerrit Veen - Otto Kamp - Jean GF Bronzwaer - Cees A Visser - Frans C Visser

Source: https://link.springer.com/







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