| The Danish multicentre randomized study of fibrinolytic therapy vs. primary angioplasty in acute myocardial infarction (the DANAMI-2 trial): outcome after 3 years follow-up. | |
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MedLine Citation:
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PMID: 17956874 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The DANAMI-2 trial showed that in patients with ST-elevation myocardial infarction (STEMI), a strategy of inter-hospital transfer for primary angioplasty was superior to on-site fibrinolysis at 30 days follow-up. This paper reports on the pre-specified long-term composite endpoint at 3 years follow-up in DANAMI-2. METHODS AND RESULTS: We randomized 1572 patients with STEMI to primary angioplasty or intravenous alteplase; 1129 patients were enrolled at 24 referral hospitals and 443 patients at 5 angioplasty centres. Ninety-six percent of inter-hospital transfers for angioplasty were completed within 2 h. No patients were lost to follow-up. The composite endpoint (death, clinical re-infarction, or disabling stroke) was reduced by angioplasty when compared with fibrinolysis at 3 years (19.6 vs. 25.2%, P =0.006). For patients transferred to angioplasty compared with those receiving on-site fibrinolysis, the composite endpoint occurred in 20.1 vs. 26.7% (P = 0.007), death in 13.6 vs. 16.4% (P = 0.18), clinical re-infarction in 8.9 vs. 12.3% (P = 0.05), and disabling stroke in 3.2 vs. 4.7% (P = 0.23). CONCLUSION: The benefit of transfer for primary angioplasty based on the composite endpoint was sustained after 3 years. For patients with characteristics as those in DANAMI-2, primary angioplasty should be the preferred treatment strategy when inter-hospital transfer can be completed within 2 h. |
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Authors:
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Martin Busk; Michael Maeng; Klaus Rasmussen; Henning Kelbaek; Per Thayssen; Ulrik Abildgaard; Else Vigholt; Leif S Mortensen; Leif Thuesen; Steen D Kristensen; Torsten T Nielsen; Henning R Andersen; |
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Publication Detail:
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Type: Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2007-10-23 |
Journal Detail:
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Title: European heart journal Volume: 29 ISSN: 1522-9645 ISO Abbreviation: Eur. Heart J. Publication Date: 2008 May |
Date Detail:
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Created Date: 2008-05-15 Completed Date: 2008-07-31 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8006263 Medline TA: Eur Heart J Country: England |
Other Details:
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Languages: eng Pagination: 1259-66 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Aarhus University Hospital Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, Denmark. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic beta-Antagonists
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therapeutic use Aged Angioplasty, Transluminal, Percutaneous Coronary / methods* Aspirin / therapeutic use Female Fibrinolytic Agents / therapeutic use Follow-Up Studies Heparin / therapeutic use Humans Male Middle Aged Myocardial Infarction / therapy* Myocardial Revascularization / methods, nursing Thrombolytic Therapy / methods*, nursing* Tissue Plasminogen Activator / therapeutic use Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic beta-Antagonists; 0/Fibrinolytic Agents; 50-78-2/Aspirin; 9005-49-6/Heparin; EC 3.4.21.68/Tissue Plasminogen Activator |
| Investigator | |
Investigator/Affiliation:
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H R Andersen / ; T T Nielsen / ; K Rasmussen / ; L Thuesen / ; H Kelbaek / ; P Thayssen / ; U Abildgaard / ; F Pedersen / ; J K Madsen / ; P Grande / ; A B Villadsen / ; L R Krusell / ; T Haghfelt / ; P Lomholt / ; S E Husted / ; E Vigholt / ; H K Kjaergard / ; L S Mortensen / |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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