DANish Study of Optimal Acute Treatment of Patients With ST-elevation Myocardial Infarction

Conditions

ST Segment Elevation Myocardial Infarction

Keywords

STEMI, Ischemic postconditioning, Deferred stenting, Primary PCI

Brief summary

This study focuses on Cardioprotective strategies.

Elezi B, Marquard JM, Kelbæk H, Nepper-Christensen L, Ahtarovski K, Kyhl K, Göransson C, Islam U, Køber L, Høfsten D, Pedersen F, Vejlstrup NG, Holmvang L, Engstrøm T, Lønborg JT.

2026-01-06

10.1093/ehjci/jeag001

10-Year Outcomes of Deferred or Conventional Stent Implantation in Patients With STEMI (DANAMI-3-DEFER)

Jasmine Melissa Madsen, Thomas Engstrøm, Henning Kelbæk, Rasmus Paulin Beske, Utsho Islam et al. (20 authors)

Circulation Cardiovascular Interventions2025-05-201 citations

10.1161/circinterventions.125.015369

Scar border zone mass and presence of border zone channels assessed with cardiac magnetic resonance imaging are associated with ventricular arrhythmia in patients with ST-segment elevation myocardial infarction

Anna F. Thomsen, Litten Bertelsen, Christian Jøns, Reza Jabbari, Jacob Lønborg et al. (16 authors)

EP Europace2022-12-2821 citations

10.1093/europace/euac256

Cardiovascular magnetic resonance characteristics and clinical outcomes of patients with ST-elevation myocardial infarction and no standard modifiable risk factors–A DANAMI-3 substudy

J. Mazhar, Kathrine Ekström, Rebecca Kozor, Stuart M. Grieve, Lars Nepper‐Christensen et al. (14 authors)

Frontiers in Cardiovascular Medicine2022-08-0310 citations

10.3389/fcvm.2022.945815

Ischemia From Nonculprit Stenoses Is Not Associated With Reduced Culprit Infarct Size in Patients with ST-Segment–Elevation Myocardial Infarction

Kathrine Ekström, Julie V.W. Nielsen, Lars Nepper‐Christensen, Kiril Aleksov Ahtarovski, Kasper Kyhl et al. (15 authors)

Circulation Cardiovascular Imaging2021-05-013 citations

10.1161/circimaging.120.012290

Interaction of ischaemic postconditioning and thrombectomy in patients with ST-elevation myocardial infarction

Lars Nepper‐Christensen, Dan Eik Høfsten, Steffen Helqvist, Jens Flensted Lassen, Hans-Henrik Tilsted et al. (19 authors)

Heart2019-07-1716 citations

10.1136/heartjnl-2019-314952

Impact of Multiple Myocardial Scars Detected by CMR in Patients Following STEMI.

Ekström K, Nepper-Christensen L, Ahtarovski KA, Kyhl K, Göransson C, Bertelsen L, Ghotbi AA, Kelbæk H, Helqvist S, Høfsten DE, Køber L, Schoos MM, Vejlstrup N, Lønborg J, Engstrøm T.

2019-04-1711 citations

10.1016/j.jcmg.2019.01.032

Benefit From Reperfusion With Primary Percutaneous Coronary Intervention Beyond 12 Hours of Symptom Duration in Patients With ST-Segment–Elevation Myocardial Infarction

Lars Nepper‐Christensen, Jacob Lønborg, Dan Eik Høfsten, Kiril Aleksov Ahtarovski, Lia E. Bang et al. (12 authors)

Circulation Cardiovascular Interventions2018-09-0148 citations

10.1161/circinterventions.118.006842

MR‐proADM as a Prognostic Marker in Patients With ST‐Segment–Elevation Myocardial Infarction—DANAMI‐3 (a Danish Study of Optimal Acute Treatment of Patients With STEMI) Substudy

Alexander Christian Falkentoft, Rasmus Rørth, Kasper Iversen, Dan Eik Høfsten, Henning Kelbæk et al. (20 authors)

Journal of the American Heart Association2018-05-1823 citations

10.1161/jaha.117.008123

Myocardial Damage in Patients With Deferred Stenting After STEMI: A DANAMI-3-DEFER Substudy.

Lønborg J, Engstrøm T, Ahtarovski KA, Nepper-Christensen L, Helqvist S, Vejlstrup N, Kyhl K, Schoos MM, Ghotbi A, Göransson C, Bertelsen L, Holmvang L, Pedersen F, Jørgensen E, Saunamäki K, Clemmensen P, De Backer O, Kløvgaard L, Høfsten DE, Køber L, Kelbæk H, DANAMI-3 Investigators.

2017-06-0138 citations

10.1016/j.jacc.2017.03.601

Effect of Ischemic Postconditioning During Primary Percutaneous Coronary Intervention for Patients With ST-Segment Elevation Myocardial Infarction

Thomas Engstrøm, Henning Kelbæk, Steffen Helqvist, Dan Eik Høfsten, Lene Kløvgaard et al. (33 authors)

JAMA Cardiology2017-03-01127 citations

10.1001/jamacardio.2017.0022

Association Between Early Q Waves and Reperfusion Success in Patients With ST-Segment–Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention

Divan Gabriel Topal, Jacob Lønborg, Kiril Aleksov Ahtarovski, Lars Nepper‐Christensen, Steffen Helqvist et al. (20 authors)

Circulation Cardiovascular Interventions2017-03-0113 citations

10.1161/circinterventions.116.004467

Left Ventricular Hypertrophy Is Associated With Increased Infarct Size and Decreased Myocardial Salvage in Patients With ST‐Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Lars Nepper‐Christensen, Jacob Lønborg, Kiril Aleksov Ahtarovski, Dan Eik Høfsten, Kasper Kyhl et al. (18 authors)

Journal of the American Heart Association2017-01-1055 citations

10.1161/jaha.116.004823

Deferred versus conventional stent implantation in patients with ST-segment elevation myocardial infarction (DANAMI 3-DEFER): an open-label, randomised controlled trial.

Kelbæk H, Høfsten DE, Køber L, Helqvist S, Kløvgaard L, Holmvang L, Jørgensen E, Pedersen F, Saunamäki K, De Backer O, Bang LE, Kofoed KF, Lønborg J, Ahtarovski K, Vejlstrup N, Bøtker HE, Terkelsen CJ, Christiansen EH, Ravkilde J, Tilsted HH, Villadsen AB, Aarøe J, Jensen SE, Raungaard B, Jensen LO, Clemmensen P, Grande P, Madsen JK, Torp-Pedersen C, Engstrøm T.

2016-04-03139 citations

10.1016/s0140-6736(16)30072-1

A randomized trial of deferred stenting versus immediate stenting to prevent no- or slow-reflow in acute ST-segment elevation myocardial infarction (DEFER-STEMI).

Carrick D, Oldroyd KG, McEntegart M, Haig C, Petrie MC, Eteiba H, Hood S, Owens C, Watkins S, Layland J, Lindsay M, Peat E, Rae A, Behan M, Sood A, Hillis WS, Mordi I, Mahrous A, Ahmed N, Wilson R, Lasalle L, Généreux P, Ford I, Berry C.

2014-02-27190 citations

10.1016/j.jacc.2014.02.530

Interventions

OTHERConventional primary PCI

Conventional primary PCI in STEMI with implantation of DES.

OTHERIschemic postconditioning.

Primary PCI in STEMI with implantation of DES. Following re-opening of the culprit artery mechanical postconditioning with 4 cycles of 30/30 sec. reperfusion/re-occlusion i performed.

OTHERDeferred stenting in primary PCI.

In STEMI re-opening of the artery with guidewire/thrombectomy/small size balloon inflation DES stenting is postponed for 48 hours.

Study design

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

TREATMENT

Masking

SINGLE (Subject)

Eligibility

Sex/Gender

ALL

Healthy volunteers

No

Inclusion criteria

* Age ≥ 18 years. * Acute onset of chest pain of \< 12 hours' duration. * ST-segment elevation ≥ 0.1 mV in ≥ 2 contiguous leads, signs of a true posterior infarction or documented newly developed left bundle branch block. Culprit lesion in a major native vessel.

Exclusion criteria

* Pregnancy. * Known intolerance of ASA, clopidogrel, heparin or contrast. * Inability to understand information or to provide informed consent. * Haemorrhagic diathesis or known coagulopathy. * Stent thrombosis.

Design outcomes

Primary

Measure	Time frame
All cause mortality, heart failure (postconditioning)	2 years

Secondary

Measure	Time frame	Description
Infarct size in relation to area at risk as determined by MRI after 3 month	3 month	Infarct size Salvage index
All cause mortality, myocardial infarction, repeat revascularisation and occurrence of definite stent thrombosis according to ARC definition within 1 year (deferred stent strategy)	1 year	—

Other

Measure	Time frame
LVEF (MRI)	90 days
Infarct size (MRI)	90 days
TIMI flow	postprocedure
Quality of life	1 year
Microvascular obstruction (MVO)	within 48 hours
ST-segment resolution	90 min postprocedure
Wall motion index (echo)	1 year

Countries

Denmark

Outcome results

None listed