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- angioplasty (transluminal, percutaneous coronary)
- fibrinolytic agents
- myocardial infarction
- patient transfer
Q Is the transfer of patients with ST-segment elevation myocardial infarction (STEMI) to an invasive treatment centre (ITC) for primary angioplasty (percutaneous coronary intervention [PCI]) more effective than onsite fibrinolysis for reducing all cause mortality, reinfarction, or stroke?
Clinical impact ratings GP/FP/Primary care ★★★★★☆☆ IM/Ambulatory care ★★★★★★☆ Internal medicine ★★★★★★☆ Cardiology ★★★★★☆☆ Emergency medicine ★★★★★★☆
METHODS
Design:
randomised controlled trial (Danish trial in Acute Myocardial Infarction-2 [DANAMI-2]).
Allocation:
concealed.*
Blinding:
blinded (outcome assessors).*
Follow up period:
30 days.
Setting:
24 referral hospitals (RHPs) and 5 ITCs in Denmark.
Patients:
1572 patients ⩾18 years age (median age 63 y, 73% men) who had STEMI. Exclusion criteria included contraindication to fibrinolysis and left bundle branch block.
Intervention:
patients were stratified by hospital and allocated to PCI (n = 567 at RHPs and 223 at ITCs) or fibrinolysis (n = 562 at …
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