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Evaluating the Optimal Timing of Revascularisation in Patients with Transient ST-Segment Elevation Myocardial Infarction: Rationale and Design of the TRANSIENT Trial

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Abstract

Patients with chest pain and a prehospital ST-segment elevation myocardial infarction (STEMI) are preferably treated with immediate percutaneous coronary intervention (PCI). However, patients with normalization of symptoms and ST-segment elevation upon hospital arrival (transient STEMI) received inconsistent therapy due to logistic reasons and the absence of evidence or explicit guidelines. In this trial, the optimal timing of coronary angiography and subsequent revascularisation is investigated in patients presenting with transient STEMI. In this prospective, multicentre, randomized controlled clinical trial, 142 consecutive patients with initially acute chest pain and STEMI, whose symptoms and ST-segment elevation resolve upon admission, are randomized to immediate intervention or a delayed intervention. Primary outcome is infarct size measured at 4 days determined by cardiovascular magnetic resonance. Secondary outcomes are left ventricular function and volumes, myocardial salvage and microvascular injury at baseline; the change in left ventricular function, volumes and infarct size at 4 months; and major adverse cardiac events at 4 and 12 months. The TRANSIENT Trial evaluates whether a delayed invasive strategy (according to NSTEMI-guidelines) is superior to an immediate invasive strategy (according to STEMI-guidelines) in patients with a transient STEMI.

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Financial Support

The study is financially supported by unrestricted grants from Astra-Zeneca and Biotronik.

Trial Registration Number

NTR4156 (www.trialregister.nl)

Author information

Authors and Affiliations

  1. Department of Cardiology, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands

    Jorrit Lemkes, Robin Nijveldt, Aernout M. Beek, Paul Knaapen, Cor P. Allaart, Albert van Rossum & Niels van Royen

  2. Institute for Cardiovascular Research ICaR-VU, VU University Medical Center, Amsterdam, The Netherlands

    Jorrit Lemkes, Robin Nijveldt, Aernout M. Beek, Paul Knaapen, Cor P. Allaart, Albert van Rossum & Niels van Royen

  3. Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands

    Alexander Hirsch

  4. Department of Experimental Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands

    Joost Meijers

Authors
  1. Jorrit Lemkes
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  2. Robin Nijveldt
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  3. Aernout M. Beek
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  4. Paul Knaapen
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  5. Alexander Hirsch
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  6. Joost Meijers
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  7. Cor P. Allaart
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  8. Albert van Rossum
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  9. Niels van Royen
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Corresponding author

Correspondence to Jorrit Lemkes.

Additional information

Associate Editor Emanuele Barbato oversaw the review of this article.

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Lemkes, J., Nijveldt, R., Beek, A.M. et al. Evaluating the Optimal Timing of Revascularisation in Patients with Transient ST-Segment Elevation Myocardial Infarction: Rationale and Design of the TRANSIENT Trial. J. of Cardiovasc. Trans. Res. 7, 590–596 (2014). https://doi.org/10.1007/s12265-014-9572-6

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  • DOI: https://doi.org/10.1007/s12265-014-9572-6

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