April 23, 2026 — Researchers presented data on the secondary endpoints from STEMI-DTU (ST-segment Elevation Myocardial Infarction Door-To-Unload) at the Society for Cardiovascular Angiography & Interventions (SCAI) 2026 Scientific Sessions & Canadian Association of Interventional Cardiology/Association Canadienne de cardiologie d’intervention (CAIC-ACCI) Summit in Montreal.
Current treatment for ST-elevation myocardial infarction (STEMI) focuses on quickly restoring blood flow to the affected coronary artery through percutaneous coronary intervention (PCI), helping to reestablish oxygen delivery to the heart. Despite these advances, outcomes remain concerning — particularly among patients over 65 experiencing their first heart attack. Although significant strides have been made in the methods clinicians use to reopen blocked arteries, heart tissue death during the procedure remains a concern.
The STEMI-DTU trial is an open-label, randomized controlled trial and the first-of-its-kind to test whether the combination of mechanical left ventricular (LV) unloading plus a 30-minute delay before PCI reduces infarct size compared with immediate PCI alone in patients with anterior STEMI without cardiogenic shock. Between December 2019 and September 2024, 527 patients were randomized at 66 sites in the United States, Germany, Italy, the United Kingdom, Switzerland, and Canada. The mean age was 61 years, and 79% of the patients were male. This analysis evaluated the powered secondary safety endpoint of treatment-related major bleeding or vascular complications at 30 days.
Major bleeding and vascular complications in the trans-valvular micro-axial flow pump (TVmAFP) arm were predominantly BARC3 bleeding without transfusions and access-site related. Additionally, major bleeding and vascular complications showed a stronger relationship with mortality in the control group than in the TVmAFP group.
“Key insights from the STEMI-DTU trial continue to educate us about the importance of technique and bleeding complications,” said Norman Mangner, MD, cardiologist and Deputy Director at Heart Center Dresden, TU Dresden in Dresden, Germany.
More details on the session are available at “STEMI Door To Unload Trial: In-Depth Analysis of the Secondary Safety Endpoint.”
November 03, 2026 
