October 2, 2012Current Opinion in Cardiology
Optimal selection of STEMI treatment strategies in the current era
Why the study?
Does transfer for primary PCI reduce mortality compared to onsite fibrinolytic therapy in STEMI patients when accounting for PCI-related delays?
Population
19,012 propensity-score matched STEMI patients from the National Registry of Myocardial Infarction database
Comparison
Transfer for primary percutaneous coronary… vs Onsite fibrinolytic therapy (O-FT)
Design
Review
Authors
Discussion
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Member takes
Implication
Time-dependent benefit warrants delay-aware STEMI triage; leaves open precise cutoffs in contemporary systems.
Structured PICO
Does transfer for primary PCI reduce mortality compared to onsite fibrinolytic therapy in STEMI patients when accounting for PCI-related delays?
P
Population
19,012 propensity-score matched STEMI patients from the National Registry of Myocardial Infarction database (as discussed in the review)
I
Intervention
Transfer for primary percutaneous coronary intervention (X-PCI)
C
Comparator
Onsite fibrinolytic therapy (O-FT)
O
Outcome
Mortalityhard clinical
The mortality benefit of transferring STEMI patients for primary PCI over onsite fibrinolysis is highly time-dependent and is nullified when PCI-related delays reach approximately 120 minutes.
Cite This Study
Chakrabarti et al. (2012) studied this question.