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  • Primary percutaneous coronary intervention in ST-segment elevation myocardial infarction is more effective than fibrinolysis at reducing the composite outcome of death or reinfarction after 8 years

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Therapeutics
DANAMI-2 randomised controlled trial
Primary percutaneous coronary intervention in ST-segment elevation myocardial infarction is more effective than fibrinolysis at reducing the composite outcome of death or reinfarction after 8 years
  1. Ali Emin Denktas
  1. University of Texas at Houston, Houston, Texas, USA
  1. Correspondence to Ali Emin Denktas
    6431 Fannin, MSB 1.246, Houston, TX 77030, USA; ali.e.denktas{at}uth.tmc.edu

https://doi.org/10.1136/ebm1108

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    Commentary on:

    1. Nielsen PH,
    2. Maeng M,
    3. Busk M,
    4. et al
    .; DANAMI-2 Investigators. Primary angioplasty versus fibrinolysis in acute myocardial infarction: long-term follow-up in the Danish acute myocardial infarction 2 trial. Circulation 2010;121:1484–91.
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    Context

    Rapid restoration blood flow in the infarct related artery is the goal of treatment in ST-segment elevation myocardial infarction (STEMI) patients. The question answered in this study was whether the benefit of primary Percutaneous coronary intervention (PCI) in STEMI when compared to on site fibrinolysis extends to the median follow-up time of 7.8 years.

    Methods

    This study included patients in Denmark with STEMI. Patients with cardiogenic shock, LBBB and those who had a prior MI treated with fibrinolysis within 30 days were excluded. The patients were randomised to receive fibrinolysis versus primary PCI even when they presented to a local hospital without primary PCI abilities and were transferred to the PCI hospital.

    The primary end point of this particular study was the combined end …

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    Footnotes

    • Competing interests AED received moderate grant support from PDL Biopharma for the AMICO trial.