Availability of on-site catheterization and clinical outcomes in patients receiving fibrinolysis for ST-elevation myocardial infarction
| Autor: | J, Llevadot, R P, Giugliano, E M, Antman, R G, Wilcox, E P, Gurfinkel, T, Henry, C H, McCabe, A, Charlesworth, S, Thompson, J C, Nicolau, U, Tebbe, Z, Sadowski, E, Braunwald |
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| Rok vydání: | 2001 |
| Předmět: |
Adult
Male Cardiac Catheterization medicine.medical_specialty Adolescent medicine.medical_treatment Myocardial Infarction LANOTEPLASE Coronary Angiography Revascularization Health Services Accessibility law.invention Electrocardiography Patient Admission Double-Blind Method Fibrinolytic Agents Randomized controlled trial Risk Factors law Fibrinolysis Myocardial Revascularization medicine Humans In patient Myocardial infarction Cardiac Surgical Procedures Intensive care medicine Aged medicine.diagnostic_test business.industry Data Collection ST elevation Middle Aged medicine.disease Survival Analysis United Kingdom Treatment Outcome Emergency medicine Female Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | European Heart Journal. 22:2104-2115 |
| ISSN: | 0195-668X |
| DOI: | 10.1053/euhj.2001.2622 |
| Popis: | To compare management and clinical outcomes in hospitals stratified by the availability of on-site catheterization in InTIME-II, a multicentre trial comparing alteplase with lanoteplase for acute myocardial infarction.We studied 15,078 patients enrolled in 35 countries and 855 hospitals. Thirty-one percent of hospitals had 24-h, 25% day-only, and 44% no on-site catheterization facilities. Rates of cardiac angiography (57%, 38%, 26%) and revascularization (37%, 21%, 17%) were higher in hospitals with increasing access to on-site facilities(P0.0001). The presence of a 24-h on-site facility was the strongest predictor of angiography during the index admission (odds ratio 4.17, 95% CI 3.85-4.54). There were no major differences in patient outcomes at 30 days when hospitals were stratified by availability of on-site catheterization. Adjusted 1-year mortality was similar between groups of hospitals (odds ratio for day-only 0.94 [0.80-1.09] and odds ratio for no availability 0.95 [0.83-1.10] compared to hospitals with 24-h facilities).There is a marked variation in procedure use by the availability of on-site catheterization with no major differences in patient outcomes. There is a need for additional randomized trials in the current era to address both the appropriate selection of patients and timing of invasive procedures in ST-elevation acute myocardial infarction. |
| Databáze: | OpenAIRE |
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