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January 1, 2003European Heart JournalOpen Access

Angioplasty vs thrombolysis for acute myocardial infarction: a quantitative overview of the effects of interhospital transportation

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Why the study?

Does primary angioplasty, including when requiring interhospital transportation, reduce mortality and major adverse cardiac events compared to thrombolysis in patients with acute STEMI?

Population

6,478 patients with acute ST segment elevation myocardial infarction pooled from randomized trials

Comparison

Primary angioplasty vs Thrombolytic therapy

Design

Meta-analysis

Follow-up

30 days or 6 weeks

Authors

FZFelix ZijlstraInterventional Cardiology

Discussion

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Implication

Supports primary angioplasty over thrombolysis for STEMI including transfers; confirms and extends RCT meta-evidence to interhospital settings.

Structured PICO

Does primary angioplasty, including when requiring interhospital transportation, reduce mortality and major adverse cardiac events compared to thrombolysis in patients with acute STEMI?

P
Population
6,478 patients with acute ST segment elevation myocardial infarction pooled from randomized trials
I
Intervention
Primary angioplasty (including after interhospital transportation)
C
Comparator
Thrombolytic therapy (including on-site thrombolysis)
O
Outcome
Mortality and Major adverse cardiac events (MACE) defined as the combination of death and non-fatal reinfarction, or death, non-fatal reinfarction and stroke at 30 days or 6 weekscomposite

Primary angioplasty is superior to thrombolysis for acute STEMI, and this benefit is maintained even when interhospital transportation is required to perform the procedure.

Cite This Study

Felix Zijlstra (2003) studied this question.

synapsesocial.com/papers/6a701e89439bab0cabc305dbhttps://doi.org/10.1016/s0195-668x(02)00693-0
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Comparison of Primary Coronary Angioplasty and Intravenous Thrombolytic Therapy for Acute Myocardial Infarction1997 · 1,007 citations
  2. 2The Association between Hospital Volume and Survival after Acute Myocardial Infarction in Elderly Patients1999 · 377 citations
  3. 3Transferring patients for primary angioplasty: a retrospective analysis of 104 selected high risk patients with acute myocardial infarction1997 · 66 citations
  4. 4Multicentre randomized trial comparing transport to primary angioplasty vs immediate thrombolysis vs combined strategy for patients with acute myocardial infarction presenting to a community hospital without a catheterization laboratory. The PRAGUE Study2000 · 522 citations
  5. 5The Volume of Primary Angioplasty Procedures and Survival after Acute Myocardial Infarction2000 · 379 citations