Document Detail


The impact of time to thrombolytic treatment on outcome in patients with acute myocardial infarction. For the CORE investigators (Collaborative Organisation for RheothRx Evaluation).
MedLine Citation:
PMID:  10908248     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To examine the impact of time to thrombolytic treatment on multiple acute outcome variables in a single trial of thrombolysis in acute myocardial infarction. DESIGN AND PATIENTS: Mortality and reinfarction rate were measured in 2770 patients with acute myocardial infarction who received thrombolysis within 12 hours in CORE, an international, dose ranging trial of poloxamer 188. Tc-99m sestamibi infarct size and radionuclide angiographic ejection fraction substudies included 1099 and 1074 patients, respectively. RESULTS: Time to thrombolysis, subgrouped by intervals (< 2, 2-4, > or = 4-6, and > or = 6 hours), was significantly associated with infarct size (median 15.0%, 18.5%, 22.0%, 18.5% of left ventricle; p = 0.033), mean (SD) ejection fraction (51.5 (12.0)%, 48. 3 (13.9)%, 48.2 (13.3)%, 48.2 (15.0)%; p = 0.006), 35 day mortality (5.7%, 7.1%, 7.9%, 12.5%; p = 0.0004), six month mortality (7.3%, 8. 6%, 10.4%, 15.5%; p < 0.0001), and 35 day reinfarction rate (6.1%, 3. 2%, 4.0%, 0.9%; p = 0.0001). CONCLUSIONS: In this single large trial, the beneficial effect of time to thrombolysis on infarct size and ejection fraction was restricted to treatment given within two hours of symptom onset, while the effect on mortality was evident over all time intervals. Reinfarction rate was higher in patients treated with earlier thrombolysis.
Authors:
P Chareonthaitawee; R J Gibbons; R S Roberts; T F Christian; R Burns; S Yusuf
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Publication Detail:
Type:  Case Reports; Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  84     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2000 Aug 
Date Detail:
Created Date:  2000-09-06     Completed Date:  2000-09-06     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  142-8     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic and Foundation, Rochester, MN, USA. panithaya.chareonthaitawee@csc.mrc.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Humans
Male
Middle Aged
Myocardial Infarction / drug therapy*,  physiopathology,  radionuclide imaging
Odds Ratio
Poloxamer / therapeutic use
Recurrence
Stroke Volume / drug effects
Thrombolytic Therapy / methods*
Time Factors
Tomography, Emission-Computed, Single-Photon
Treatment Outcome
Chemical
Reg. No./Substance:
106392-12-5/Poloxamer
Comments/Corrections

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