Southwest German Interventional Study in Acute Myocardial Infarction III

Southwest German Interventional Study in Acute Myocardial Infarction III

SIAM III was a multicenter, randomized, prospective, controlled trial in patients with ST-elevation myocardial infarction receiving fibrinolysis <12 hours after onset of symptoms. Patients of the early PCI group were transferred within 6 hours after fibrinolysis for PCI. The conservative group received elective PCI two weeks after fibrinolysis.

SIAM III was a multicenter, randomized, prospective, controlled trial in patients with ST-elevation myocardial infarction receiving fibrinolysis <12 hours after onset of symptoms. All patients received reteplase, aspirin in combination with ticlopidin, and heparin. Patients of the early PCI group were transferred within 6 hours after fibrinolysis for PCI. The conservative group received elective PCI two weeks after fibrinolysis. In total 197 patients were included, 163 were treated by PCI. The primary end point was the composite of ischemic events, death, reinfarction, and target lesion revascularization.

Inclusion Criteria:

• Symptoms of MI present for 12 h
• ST segment elevation of at least 1 mm in two or more limb leads,
• ST segment elevation of at least 2 mm in the precordial leads,
• or new bundlebranch block
• Patients eligible for thrombolysis
• Informed consent for participation

Exclusion Criteria:

• Secondary or iatrogenic infarction
• Chronic renal insufficiency requiring dialysis
• Coronary anatomy unsuitable for stent placement
• Anticipated indication for surgical coronary revascularization within 6 months
• Previous MI in the area of the infarct related vessel
• Infarct related lesion not clearly defined