Door-to-unload: left ventricular unloading before reperfusion in ST-elevation myocardial infarction.

Abstract

ST-elevation myocardial infarction treatment in the modern era has focused on minimizing time of ischemia by reducing door-to-balloon time to limit infarct size and improve survival. Although there have been significant improvements in minimizing time to coronary reperfusion, the incidence of heart failure following a myocardial infarction has remained high. Preclinical studies have shown that unloading the left ventricle for 30\xa0min prior to coronary reperfusion can reduce infarct size and promote myocardial recovery. The DTU-STEMI randomized prospective trial will test the hypothesis that left ventricular unloading for at least 30\xa0min prior to coronary reperfusion will improve infarct size and heart failure-related events as compared with the current standard of care.