The American College of Cardiology Presented by Dr. Adnan Kastrati BRAVE-2 Trial Bavarian Reperfusion Alternatives Evaluation 2: PCI versus medical therapy in late-presentation MI patients Presented at The American College of Cardiology Scientific Sessions 2005 Presented by Dr. Adnan Kastrati

BRAVE-2 Trial 365 patients with MI presenting >12 hours after symptom onset Without ongoing chest pain or Killip class 3/4 Invasive Angiography, then PCI if necessary Mean randomization to PCI time: 1.5 hrs Conservative Conventional medical therapy Endpoints: Primary – Infarct size determined by SPECT at 5-10 days Secondary – Death, MI, stroke, at 30 days ACC 2005

BRAVE-2: Primary endpoint Infarct Size (% of left ventricle) p = 0.002 The primary endpoint of infarct size determined by SPECT at 5-10 days was significantly lower in the invasive arm compared to the conservative arm. ACC 2005

BRAVE-2: Secondary Endpoints At 30 days, there was no statistically significant difference in clinical end points between the invasive and conservative arms. p = 0.37 p = 0.21 p = 0.4 ACC 2005

BRAVE - 2: Summary Among patients with MI presenting more than 12 hours after symptom onset, invasive treatment was associated with a significant reduction in the primary endpoint of infarct size compared to conservative treatment with medical therapy Clinical endpoints of death, MI and stroke were similar between the groups at 30 days Further evaluation of the benefit of PCI among late-presenting asymptomatic STEMI patients appears warranted ACC 2005