Document Detail


Stenting versus thrombolysis in acute myocardial infarction trial (STAT).
MedLine Citation:
PMID:  11263625     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We sought to directly compare primary stenting with accelerated tissue plasminogen activator (t-PA) in patients presenting with acute ST-elevation myocardial infarction (AMI). BACKGROUND: Thrombolysis remains the standard therapy for AMI. However, at some institutions primary angioplasty is favored. Randomized trials have shown that primary angioplasty is equal or superior to thrombolysis, while recent studies demonstrate that stent implantation improves the results of primary angioplasty. METHODS: Patients presenting with AMI were randomly assigned to primary stenting (n = 62) or accelerated t-PA (n = 61). The primary end point was the composite of death, reinfarction, stroke or repeat target vessel revascularization (TVR) for ischemia at six months. RESULTS: The primary end point was significantly reduced in the stent group compared with the accelerated t-PA group, 24.2% versus 55.7% (p < 0.001). The event rates for other outcomes in the stent group versus the t-PA group were as follows: mortality: 4.8% versus 3.3% (p = 1.00); reinfarction: 6.5% versus 16.4% (p = 0.096); stroke: 1.6% versus 4.9% (p = 0.36); recurrent unstable ischemia: 9.7% versus 26.2% (p = 0.03) and repeat TVR for ischemia: 14.5% versus 49.2% (p < 0.001). The median length of the initial hospitalization was four days in the stent group and seven days in the t-PA group (p < 0.001). CONCLUSIONS: Compared with accelerated t-PA, primary stenting reduces death, reinfarction, stroke or repeat TVR for ischemia. In centers where facilities and experienced interventionists are available, primary stenting offers an attractive alternative to thrombolysis.
Authors:
M R Le May; M Labinaz; R F Davies; J F Marquis; L A Laramée; E R O'Brien; W L Williams; R S Beanlands; G Nichol; L A Higginson
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  37     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2001 Mar 
Date Detail:
Created Date:  2001-03-23     Completed Date:  2001-04-05     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  985-91     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, University of Ottawa Heart Institute, Canada. mlemay@ottawaheart.ca
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MeSH Terms
Descriptor/Qualifier:
Aged
Coronary Angiography
Female
Fibrinolytic Agents / therapeutic use
Humans
Length of Stay
Male
Middle Aged
Myocardial Infarction / drug therapy,  mortality,  radiography,  therapy*
Odds Ratio
Recurrence
Stents* / adverse effects
Stroke / etiology
Survival Rate
Thrombolytic Therapy* / adverse effects
Tissue Plasminogen Activator / therapeutic use
Treatment Outcome
Chemical
Reg. No./Substance:
0/Fibrinolytic Agents; EC 3.4.21.68/Tissue Plasminogen Activator

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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