PRAMI Trial – Review

PRAMI Trial – Review Preventive Angioplasty in Myocardial Infarction Trial (PRAMI) was conducted at five centres in the United Kingdom between 2008 and 2013. The study enrolled 465 patients with acute ST elevation myocardial infarction (STEMI) including 3 with left bundle branch block. Patients undergoing infarct related artery or culprit artery percutaneous intervention were randomized to either preventive PCI or no preventive PCI [1]. After primary PCI, subsequent PCI was recommended only for refractory angina with objective evidence of myocardial ischemia. Primary outcome measure in the PRAMI trial was a composite of death from cardiac causes, non fatal myocardial infarction or refractory angina. Patients with cardiogenic shock, previous coronary artery bypass graft (CABG) or candidates for CABG and those with only an additional chronic total occlusion were excluded from the study. The trial was stopped prematurely by the data and safety monitoring committee as conclusive evidence was obtained. Primary outcome occurred in 21 patients in the preventive PCI group and 53 patients in the no preventive PCI group, during a mean follow up of 23 months. The study authors concluded that in STEMI patients with multivessel coronary artery disease, preventive PCI in non infarct coronary arteries with major stenosis significantly reduced the risk of adverse cardiovascular events. It may be noted that as per study protocol, there was no option for a staged PCI for the non infarct...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Coronary Interventions Source Type: blogs