In Reply: In response to Drs Riezebos and Laarman, ABOARD was a study evaluating immediate vs deferred catheterization/revascularization, with patients randomized at the time of presentation. The ABOARD design therefore resembles the previous randomized studies evaluating timing of intervention, the new information being related to the delays applied to the 2 study groups.1
One group was treated with a “primary PCI” (immediate intervention) approach, while intervention in the other group was scheduled on the next working day. This study design is pragmatic, and the results are directly applicable to practice. Patients in the OPTIMA trial1 were randomized in the catheterization laboratory after a number of patients were excluded based on angiography results. One group (n = 73) underwent immediate PCI, while the other patients (n = 69) returned to the ward for a 24- to 48-hour waiting period of further medical treatment before they were brought back to the catheterization laboratory for PCI. Although the design reflects an interesting academic question about “cooling” before PCI, we do not consider it either pragmatic or directly applicable to most centers, especially those with high volumes and rapid turnover of patients.