At 14:15 pm of Barcelona’s local time onAugust 27th, news came from European Society of Cardiology Congress (ESC2017), oneof the two top academic conferences of the International CardiovascularSociety: as the only selected Late Breaking Science (LBS) study from China thisyear, EARLY-MYO-I, which was hosted by Professor Ben He from Department ofCardiology of Renji Hospital Affiliated to Shanghai Jiao Tong University Schoolof Medicine, was earlier announced in the list of LBS highlights. It isreported that the relevant academic paper has been accepted by "Circulation",which is an international authoritative journal in the field of Cardiology. Thepaper has also received key editorial comments in the same issue, which will bepublished at the same time with the congress.

In the afternoon of Barcelona's local timeon August 27th, the most popular academic special of this annual event, LBS, broughttogether experts and scholars from around the world. The venue which couldaccommodate more than 5,000 people is packed. Everyone is eagerly hoped to knowthe upcoming release of the academic achievements which would bring a majorbreakthrough for the future development in the field of cardiovascular researchin the congress this year. Local time at 14:15 pm, Professor Ben He boarded therelease podium of ESC2017 LBS with his latest research results of EARLY-MYO-I.EARLY-MYO-I is a prospective, multicenter, randomized controlled study focusedto compare efficacy and safety of two treatment strategies, that are earlyintervention therapy (AF-PCI) and "direct intervention therapy(PPCI)", for patients with acute ST-elevation myocardial infarction(STEMI) within 6 hours. The results of the study published by Prof. Ben He showedthat for patients with STEMI who had been delayed for more than 1 hour afteronset of symptom within 6 hours, compared with the prioritized directintervention therapy recommended by the existing guidelines, thrombolysisthrough administration of half dosage of alteplase, early intervention therapywithin 3-24 hours after the success of thrombolysis have similar efficacy andsafety. The intervention therapy after thrombolysis even obtains betterepicardial and myocardial reperfusion levels than direct intervention therapy,and also tends to improve clinical hard end although not reaching statisticalsignificance.

How to deal with it, if there is nocondition to perform direct intervention therapy for the patients with acutemyocardial infarction? Are the effects of early intervention therapy afterthrombolysis and direct intervention therapy similar? Data show that each year Chinahas 500,000 new patients with acute myocardial infarction, bringing a seriousthreat to national health. The principle for rescuing myocardial infarction isthat "Time is the myocardium and time is life". Early reperfusiontherapy, that is, as soon as possible to restore the blood supply of the heart isessential. There are two kinds of traditional reperfusion therapy, thrombolytictherapy and intervention therapy. The former is to reduce or eliminate theeffects of coronary artery thrombosis by intravenous thrombolytic drugs; thelatter is direct dilatation through the use of stent or balloon in the stenosisor occlusion of coronary artery to restore reperfusion of blood flow. Becausethe effects of direct intervention therapy is more reliable than thrombolysisalone, the incidence of re-infarction is low, so direct intervention therapyhas become the main recommendation of STEMI treatment as Class I Recommended Treatmentin both domestic and foreign guidelines with the development of heartintervention technology and equipment,. However, different from the strictconditions of clinical research, the reality of medical scenes are oftencomplex and varied. For example, in our country, due to broad territory, largeproportion of mountainous areas, uneven economic development, unevendistribution of medical resources and other reasons, the proportion of STEMIpatients in China who received direct intervention therapy is less than 1/10. Evenin this part of patients with intervention therapy, a large part of themcouldn’t receive timely treatment within the time window as the guidelines. Asa result, many patients in the real world are missing the best chance of earlyreperfusion during the process of waiting for treatment. This is the reason whythe overall mortality rate of acute myocardial infarction is not reducedcorrespondently, despite the significant increase in intervention therapy inour country.

In view of the important problems that needto be solved in clinical practice, Prof. Ben He has led the medical team inDepartment of Cardiology of Renji Hospital to carry out a series of research since2011 to firstly put forward the new strategy of "Early interventiontherapy after thrombolysis" in the country. The organic combination of the"fast" of drug thrombolysis therapy and the "stable" of directintervention therapy would provide a better treatment option for patients withmyocardial infarction who were unable to obtain timely reperfusion therapy. Onthe basis of the previous research results, the EARLY-MYO-I study was carriedout in seven cardiovascular centers in combination with Department of Cardiologyof Renji Hospital. The publication of the final research results proved theeffectiveness and safety of the strategy of "Early intervention therapyafter thrombolysis", and strengthened the understanding of the wholeprocess of myocardial infarction. It also put forward the medical concept oftreatment strategy which take the most beneficial to the patients according todifferent countries and regions, different geographical conditions, different levelsof economic development, or the availability of different technologies. This hasimportant both academic and practical significance for treatment of myocardialinfarction all over the world. Therefore, the research had received widespreadconcern and was spoke highly by the international cardiovascular community sincethe notice stage of the meeting. Under the background of the currentdevelopment of chest pain center in China, research results of EARLY-MYO-I willhelp cardiovascular physicians at all levels to betterunderstand selection of different treatment strategies for acute myocardialinfarction, but also provide an important evidence-based basis for the layoutof graded medical resources and the construction of network treatment system formyocardial infarction in the future in China.