The PULSE-MI trial

Prehospital single-pulse-dose steroid in patients with STEMI 🚑 🫀 An investigator-initiated, 1:1 randomized, blinded, placebo-controlled trial

[Ignacio Seropian MD @ISeropianMD]

👏 👏 to the @PULSEMI_trial inv!! A “negative” trial that is v important for sev reasons:
1) There’s an old belief that GC are ☠️ in #AMI
2) Some surrog of impr outcome

We can say there’s no harm 💪….Somenthign we’ve been writing with @AbbateAntonio & @bvantassell some yr ago

[Jasmine Melissa Marquard @JasmineMarquard]

WHAT A MILESTONE!
On behalf of everyone behind the trial, I just presented the results of the @PULSEMI_trial at #ESCCongress 🚑
Prehospital glucocorticoid did not reduce final infarct size BUT it is safe, ⬆️ acute LVEF, ⬇️ acute infarct size and MVO! Read the more in @JAMACardio

[JAMA Cardiology @JAMACardio]

Results of the PULSE-MI trial show that in pts with STEMI, prehospital pulse-dose glucocorticoid did not reduce final infarct size after 3 mos. Patients treated with glucocorticoid had higher acute LVEF, reduced acute infarct size, & less MVO. https://t.co/mRdKYlvBX2 #ESCCongress

[JAMA @JAMA_current]

From @JAMACardio: Results of PULSE-MI trial show in pts w/ STEMI, prehospital pulse-dose glucocorticoid did not reduce final infarct size after 3 mos. Pts treated w/ glucocorticoid had higher acute LVEF, reduced acute infarct size, & less MVO. https://t.co/V8J0KjgNLa #ESCCongress

[RigsHeart 🫀🚨 @RigsHeart]

@JasmineMelissaMadsen presenting results from the #RCT #PulseMI

MI size was not reduced by iv. glucocorticoid prehospital 🚑💉

[The PULSE-MI trial @PULSEMI_trial]

Hope to see you at #ESC2024!

[Jasmine Melissa Marquard @JasmineMarquard]

🔥 We are so excited (!) and thrilled to be able to share the results of the @PULSEMI_trial at an exciting #LateBreakingScience session at #ESC2024 in London this August! 🫀 @RigsHeart

[The PULSE-MI trial @PULSEMI_trial]

@EmilHolckMD @laustemil The trial was not powered for clinical outcome, unfortunetly. There is a trend in mortality - aslo in subanalysis, right @laustemil ??

[The PULSE-MI trial @PULSEMI_trial]

Dr. @laustemil just presented the primary results of #STEROHCA; An RCT investigating the effect of pulse-dose methylprednisolone in patients with OHCA!
These findings are intriguing!! We have now seen the results on brain injury and inflammation. What about #MyocardialInjury? 🫀

[Tommaso Scquizzato, MD @tscquizzato]

@laustemil Methylprednisolone 250 mg compared to placebo after ROSC in 120 OHCA patients was safe, reduced IL-6, but had no effect on brain injury and outcomes

#LIVES2023 #STEROHCA @laustemil

[The PULSE-MI trial @PULSEMI_trial]

@JasmineMMadsen @laustemil @CHassager @engstr_thomas @FolkeFredrik @NielsVejlstrup @akutberedskabet @regionsjaelland @RegionH @Rigshospitalet

[The PULSE-MI trial @PULSEMI_trial]

WHAT A #MILESTONE!!
After JUST 11 months - today the last patient was randomized in the PULSE-MI trial! 🫀🚑

The last FU will be completed in January 2024! ✅

We are excited to share the results on the trial in the beginning of 2024! 🫀 #CardioTwitter #RCT @RigsHeart

[RigsHeart 🫀🚨 @RigsHeart]

#Thread 4/4 // The @PULSEMI_trial 🫀
Inclusion continues until 378 patients have completed the 3-months FU #CMR 🏥
Almost 60% of the FU scan are completed ✅ We expect to have the results in the beginning of 2024! 🗓️ Information and status of the trial: https://t.co/fnXOtjfvuS

[RigsHeart 🫀🚨 @RigsHeart]

#Thread 3/4 // The @PULSEMI_trial 🫀🚨
The #RCT is carried out throughout the #EMS in @regionsjaelland and @RegionH and chaired at @Rigshospitalet
PI: Dr. Jacob Lønborg; Coordinating investigator: Dr. @JasmineMMadsen; Sponsor and investigator: Prof. @engstr_thomas #CardioTwitter

[RigsHeart 🫀🚨 @RigsHeart]

#Thread 2/4 // The @PULSEMI_trial 🫀🚨
Hypothesis: In #STEMI patients, pre-hospital 🚑pulse-dose #methylprednisolone prior to primary #PCI will:
⬇️inflammation 🧫
⬇️reperfusion injury
⬇️final infarct size 🫀
Subsequently resulting in:
📈impoved clinical course following #STEMI

[The PULSE-MI trial @PULSEMI_trial]

Expected completion of follow-up #CMR: January 1st, 2024!

Hopefully we will be able to show the results in spring/summer 2024!

[RigsHeart 🫀🚨 @RigsHeart]

#Thread 1/4
Can pre-hospital treatment with #glucocorticoid have an important therapeutic role in limiting the degree of myocardial injury and improving prognosis in #STEMI patients? 🫀🚑
We are curiously awaiting the @PULSEMI_trial chaired at @rigshospitalet! #CardioTwitter

[The PULSE-MI trial @PULSEMI_trial]

@RigsHeart @laustemil @engstr_thomas @JasmineMMadsen @FolkeFredrik @akutberedskabet @regionsjaelland @RegionH @CHassager

[The PULSE-MI trial @PULSEMI_trial]

Status at 8 months
1. 390 eligible patients included 🚑
2. 300 acute #CMRs 🏥
3. 195 follow-up #CMRs 🫀

52% down, 48% to go!

[The PULSE-MI trial @PULSEMI_trial]

@JasmineMMadsen @laustemil @engstr_thomas @Rigshospitalet @CHassager @FolkeFredrik @akutberedskabet @regionsjaelland @RegionH

[The PULSE-MI trial @PULSEMI_trial]

We just completed the 131st follow-up CMR scan (35%)! The inclusion of this trial has and is incredible! 🫀🚑
Yet, it could not be possible without #teamwork all across the board! 🙏🏽 We expect to have completed the enrollment by the end of July at latest! 🥳 #RigsHeart @RigsHeart

[The PULSE-MI trial @PULSEMI_trial]

@Rigshospitalet @engstr_thomas @laustemil @JasmineMMadsen @FolkeFredrik @akutberedskabet @RegionH @regionsjaelland

[The PULSE-MI trial @PULSEMI_trial]

A total of 102 (27%) patients have now completed the 3-months follow-up #CMR! A huge milestone! 🫀🚑 #RCT