The Western Washington and Myocardial Infarction Triage and Intervention Trials of Thrombolytic Therapy: 15 Years of Collaboration in the Pacific Northwest

Beginning in 1981, collaborative efforts developed between the University of Washington and community hospitals in Washington, British Columbia, Canada, and later outside the Pacific Northwest, have generated important findings about the treatment and outcome of acute myocardial infarction (AMI). These efforts, collectively known as the Western Washington and Myocardial Infarction Triage and Intervention Project trials, have included randomized trials of thrombolytic drugs, direct antithrombins, platelet receptors, antagonists, and cell adhesion blockers, as well as the formation of registries of consecutive patients admitted to coronary care units with the diagnosis of suspected AMI. Results of these trials have demonstrated that thrombolytic therapy significantly reduces mortality and morbidity from AMI with minimal risk to patients, and that early treatment is associated with improved infarct size and better left ventricular function. The efforts of the next decade should be focused on the further removal of barriers to rapid treatment and to the evaluation of new agents, so that the devastating effects of myocardial infarction are minimized to the fullest extent.