BACKGROUND: A pharmacoinvasive (PI) strategy for early presenting ST-segment elevation @entity583 nominally reduced 30-day @entity1455 and @entity712 compared with @entity301 ( @entity301 ). We evaluated whether @entity1188 size (IS) was related to this finding. METHODS AND RESULTS: Using the peak cardiac biomarker in @entity1 randomized to PI versus @entity301 within the Strategic Reperfusion Early After @entity583 (STREAM) trial, IS was divided into 3 groups: small ( <=2 times the upper limit normal [ULN]), medium (>2 to  <=5 times the upper limit normal) and large (>5 times the upper limit normal). The association between IS and 30-day shock and @entity712 was subsequently examined. Data on 1701 of 1892 (89.9%) @entity1 randomized to PI (n=853, 50.1%) versus @entity301 (n=848, 49.9%) within STREAM were evaluated. A higher proportion of @entity301 @entity1 had a large IS (PI versus @entity301 : small, 49.8% versus 50.2%; medium, 56.9% versus 43.1%; large, 48.4% versus 51.6%; P=0.035), despite comparable intergroup ischemic times for each reperfusion strategy. As IS increased, a parallel @entity1457 and @entity712 occurred in both treatment arms, except for the small IS group. The difference in shock and @entity712 in the small IS group (4.4% versus 11.6%, P=0.026) in favor of PI likely relates to higher rates of @entity583 with the PI strategy (72.7% versus 54.3%, P=0.005). After adjustment, a trend favoring PI persisted in this subgroup (relative risk 0.40, 95% CI 0.15 to 1.06, P=0.064); no difference in treatment-related outcomes was evident in the other 2 groups. CONCLUSION: A PI strategy appears to alter the pattern of IS after ST-segment elevation @entity583 , resulting in more medium and fewer large @entity1188 compared with @entity301 . Despite a comparable number of small @entity1188 , PI @entity1 in this group had more aborted @entity583 and less 30-day shock and @entity712 . CLINICAL TRIAL REGISTRATION: URL: http://ClinicalTrials.gov. Unique identifier: NCT00623623.

XXXX Size, Shock, and @entity712 : Does Reperfusion Strategy Matter in Early Presenting @entity1 With ST-Segment Elevation @entity583 ?

@entity1 :: ('9606', 'Species') :: ['patients'] @entity712 :: ('MESH:D006333', 'Disease') :: ['congestive heart failure'] @entity301 :: ('MESH:D003327', 'Disease') :: ['primary percutaneous coronary intervention', 'PPCI'] @entity1457 :: ('MESH:D012769', 'Disease') :: ['increment in shock'] @entity1188 :: ('MESH:D007238', 'Disease') :: ['infarct', 'infarcts'] @entity583 :: ('MESH:D009203', 'Disease') :: ['myocardial infarctions', 'myocardial infarction', 'Myocardial Infarction', 'aborted myocardial infarction'] @entity1455 :: ('MESH:D012770', 'Disease') :: ['cardiogenic shock']
@entity1188 :: (MESH:D007238,Disease) :: ['Infarct']
