Contemporary outcomes of rescue percutaneous coronary intervention for acute myocardial infarction: comparison with primary angioplasty and the role of distal protection devices (EMERALD trial).

Journal Article (Journal Article;Multicenter Study)

BACKGROUND: The value of distal protection devices during rescue PCI has not been studied. METHODS: The population enrolled in a prospective, randomized multicenter trial of distal microcirculatory protection in ST-elevation MI, was stratified for those undergoing rescue (n = 93) or primary (n = 408) PCI; we performed the prespecified comparisons of distal protection in rescue and primary PCI. RESULTS: Compared to primary PCI, rescue patients had higher baseline rates of TIMI-3 flow, but lower rates of post PCI TIMI-3 flow. However, no differences in the primary endpoints of complete ST-segment resolution (STR) at 30 minutes or infarct size, or 6 month mortality were present. In rescue PCI patients, randomization to distal protection did not significantly affect infarct size, STR, mortality or other clinical events. CONCLUSION: Despite reduced rates of post-procedural TIMI-3 flow, patients undergoing rescue PCI compared to primary PCI have similar myocardial perfusion, infarct size and clinical outcomes. Distal protection did not offer any detectable benefit in this patient population.

Full Text

Duke Authors

Cited Authors

  • Dangas, G; Stone, GW; Weinberg, MD; Webb, J; Cox, DA; Brodie, BR; Krucoff, MW; Gibbons, RJ; Lansky, AJ; Mehran, R; EMERALD Investigators,

Published Date

  • June 2008

Published In

Volume / Issue

  • 155 / 6

Start / End Page

  • 1090 - 1096

PubMed ID

  • 18513524

Electronic International Standard Serial Number (EISSN)

  • 1097-6744

Digital Object Identifier (DOI)

  • 10.1016/j.ahj.2007.12.003


  • eng

Conference Location

  • United States