Reperfusion Approach in Predicted In-hospital Delay for Primary PCI in STEMI

A Randomized Controlled Study of Reperfusion Strategies in Acute ST-segment Elevation Myocardial Infarction Under Conditions of Anticipated In-hospital Delay in Primary Percutaneous Coronary Intervention Strategy: the Reperfusion Approach in Predicted In-hospital Delay for Primary PCI in STEMI (RAPID-STEMI)

This study aims at evaluating of the effectiveness of in-hospital thrombolysis for ST-segment elevation myocardial infarction in PCI centers under conditions of predicted in-hospital delay (>60 min after admission in PCI-center) of PCI. Following randomisation a strategy of early tenecteplase and additional antiplatelet and antithrombin therapy followed by catheterisation within 2-24 hours with timely coronary intervention as appropriate (or by rescue coronary intervention if required) in Group A will be compared to primary PCI performed according to local standards in Group B.

Inclusion Criteria:

• Age equal or greater than 18 years
• "Symptom onset-randomization" time interval <12 hours
• Predicted "diagnosis-pPCI" time interval equal or greater than 120 minutes
• Predicted "admission-pPCI" time interval equal or greater than 60 minutes
• Informed consent received

Exclusion Criteria:

• Medical history, procedures, medication administration or the presence of factors that would in general predispose to bleeding events and/or the inability to evaluate the study primary endpoint