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March 18, 2025Journal of InflammationOpen Access

Median IMR in the glucocorticoid group was 23 (IQR, 11-38) and 18 (IQR, 11-42) in the placebo group (p=0.49).

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Why the study?

Microvascular injury occurs in up to 50% of STEMI patients without targeted therapies, and inflammation may deleteriously affect the microcirculation.

Does prehospital pulse-dose glucocorticoid improve index of microvascular resistance in patients with STEMI transferred for primary PCI?

Population

295 STEMI patients transferred for primary PCI assessed with coronary physiology

Comparison

Prehospital methylprednisolone 250 mg vs placebo

Design

Prespecified sub-study of a 1:1 randomized, blinded, placebo-controlled clinical trial

Follow-up

24 hours

Authors

JLJacob LønborgLOLaust Emil Roelsgaard OblingRBRasmus Paulin Beske

Discussion

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Overview

Glucocorticoid did not improve IMR despite anti-inflammatory effects; leaves open whether targeted inflammation reduction can protect microcirculation in STEMI.

Structured PICO

Does prehospital pulse-dose glucocorticoid improve index of microvascular resistance in patients with STEMI transferred for primary PCI?

P
Population
295 patients with ST-segment elevation myocardial infarction (STEMI) transferred for primary percutaneous coronary intervention (PCI) who were assessed with coronary physiology (sub-study of the PULSE-MI trial)
I
Intervention
Prehospital pulse-dose glucocorticoid (methylprednisolone 250 mg)
C
Comparator
Placebo
O
Outcome
Microvascular function as index of microvascular resistance (IMR) by thermodilution after primary PCIsurrogate

Prehospital pulse-dose glucocorticoid in STEMI patients reduces inflammation at 24 hours but does not improve microvascular resistance immediately after primary PCI.

Cite This Study

Lønborg et al. (2025) studied this question.

synapsesocial.com/papers/6a85d60c88bfb3d575a6fd01https://doi.org/10.1186/s12950-025-00440-2
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