1. 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

2. 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

3. 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

4. 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

5. 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