May 8, 2009European Heart Journal
Comparison of primary angioplasty and pre-hospital fibrinolysis in acute myocardial infarction (CAPTIM) trial: a 5-year follow-up
Why the study?
Does pre-hospital fibrinolysis with transfer to an interventional facility improve 5-year mortality compared to primary angioplasty in patients with acute STEMI managed within 6 hours?
Population
840 patients managed in a pre-hospital setting within 6 hours of an acute ST-segment elevation myocardial…
Comparison
Pre-hospital fibrinolysis with immediate… vs Primary angioplasty
Design
RCT, Randomized, Long-term follow-up obtained in blinded fashion
Follow-up
5 years
Authors
Discussion
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Member takes
Implication
Supports pre-hospital fibrinolysis as a viable STEMI option; confirms comparable 5-year mortality to primary angioplasty.
Structured PICO
Does pre-hospital fibrinolysis with transfer to an interventional facility improve 5-year mortality compared to primary angioplasty in patients with acute STEMI managed within 6 hours?
P
Population
840 patients managed in a pre-hospital setting within 6 hours of an acute ST-segment elevation myocardial infarction
I
Intervention
Pre-hospital fibrinolysis (rt-PA) with immediate transfer to a center with interventional facilities
C
Comparator
Primary angioplasty
O
Outcome
All-cause mortality at 5 yearshard clinical
Pre-hospital fibrinolysis followed by transfer to an interventional center yields similar 5-year mortality to primary PCI in STEMI patients, with potentially lower mortality if treated within 2 hours of symptom onset.
Cite This Study
Bonnefoy et al. (2009) studied this question.