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Bavarian Reperfusion Alternatives Evaluation 2: PCI versus medical therapy in late-presentation MI patients

BRAVE-2 Trial. Bavarian Reperfusion Alternatives Evaluation 2: PCI versus medical therapy in late-presentation MI patients. Presented at The American College of Cardiology Scientific Sessions 2005 Presented by Dr. Adnan Kastrati. BRAVE-2 Trial.

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Bavarian Reperfusion Alternatives Evaluation 2: PCI versus medical therapy in late-presentation MI patients

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  1. BRAVE-2 Trial Bavarian Reperfusion Alternatives Evaluation 2: PCI versus medical therapy in late-presentation MI patients Presented at The American College of Cardiology Scientific Sessions 2005 Presented by Dr. Adnan Kastrati

  2. BRAVE-2 Trial 365 patients with MI presenting >12 hours after symptom onset Without ongoing chest pain or Killip class 3/4 Invasive Angiography, then PCI if necessary Mean randomization to PCI time: 1.5 hrs Conservative Conventional medical therapy • Endpoints: • Primary – Infarct size determined by SPECT at 5-10 days • Secondary – Death, MI, stroke, at 30 days ACC 2005

  3. BRAVE-2: Primary endpoint Infarct Size (% of left ventricle) p = 0.002 • The primary endpoint of infarct size determined by SPECT at 5-10 days was significantly lower in the invasive arm compared to the conservative arm. ACC 2005

  4. BRAVE-2: Secondary Endpoints At 30 days, there was no statistically significant difference in clinical end points between the invasive and conservative arms. p = 0.37 p = 0.4 p = 0.21 ACC 2005

  5. BRAVE - 2: Summary • Among patients with MI presenting more than 12 hours after symptom onset, invasive treatment was associated with a significant reduction in the primary endpoint of infarct size compared to conservative treatment with medical therapy • Clinical endpoints of death, MI and stroke were similar between the groups at 30 days • Further evaluation of the benefit of PCI among late-presenting asymptomatic STEMI patients appears warranted ACC 2005

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