Copyright © 2002 by the European Society of Cardiology.
Clinical characteristics and outcome of patients with early (<2h), intermediate (2–4h) and late (>4h) presentation treated by primary coronary angioplasty or thrombolytic therapy for acute myocardial infarction
Department of Cardiology, Hospital De Weezenlanden, Zwolle, The Netherlands
revised July 10, 2001; accepted July 11, 2001
Abstract
Aims We examined the clinical characteristics and outcome of patients with early (<2h), intermediate (2–4h) and late (>4h) presentation treated by primary angioplasty or thrombolytic therapy for acute myocardial infarction.
Methods and Results We studied 2635 patients enrolled in 10 randomized trials of primary angioplasty (n=1302) vs thrombolytic therapy (n=1333) in acute myocardial infarction, and baseline characteristics of the two groups were comparable. Increase in presentation delay is associated with older age, female gender, diabetes and an increased heart rate. We classified the patients according to the time delay from symptom onset to presentation into three categories: early presentation (<2h), intermediate presentation (2–4h), and late presentation (
4h). At 30 days the combined rate of death, non-fatal reinfarction and stroke in patients presenting early was 5·8% in the angioplasty group vs 12·5% in the thrombolysis group, in patients with intermediate presentation, 8·6% vs 14·2%, respectively, and in patients presenting late 7·7% vs 19·4%, respectively. With increasing time from symptom onset to presentation, all major adverse cardiac event rates show a trend to a larger increase in the thrombolysis group compared to the angioplasty group, both at 30 days and at 6 months after the acute event.
Conclusions Major adverse cardiac event rates are lower after angioplasty compared to thrombolysis, irrespective of time to presentation. With increasing time to presentation major adverse cardiac event rates increase after thrombolysis but appear to remain relatively stable after angioplasty.
Key Words: Myocardial infarction, thrombolytic therapy, coronary angioplasty
f1 Correspondence: Dr Felix Zijlstra, Hospital de Weezenlanden, Department of Cardiology, Groot Wezenland 20, 8011 JW Zwolle, The Netherlands.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  P. W. Armstrong, Y. Fu, C. M. Westerhout, M. P. Hudson, K. W. Mahaffey, H. D. White, T. G. Todaro, P. X. Adams, P. E.G. Aylward, and C. B. Granger Baseline Q-wave surpasses time from symptom onset as a prognostic marker in ST-segment elevation myocardial infarction patients treated with primary percutaneous coronary intervention. J. Am. Coll. Cardiol., April 28, 2009; 53(17): 1503 - 1509. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C J Terkelsen, E H Christiansen, J T Sorensen, S D Kristensen, J F Lassen, L Thuesen, H R Andersen, W Vach, and T T Nielsen Primary PCI as the preferred reperfusion therapy in STEMI: it is a matter of time Heart, March 1, 2009; 95(5): 362 - 369. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Elapsed time in emergency medical services for patients with cardiac complaints: are some patients at greater risk for delay? Circ Cardiovasc Qual Outcomes, January 1, 2009; 2(1): 9 - 15.
|
|
|
|
 |
|
 G. De Luca Adjunctive antithrombotic therapy during primary percutaneous coronary intervention Eur. Heart J. Suppl., December 1, 2008; 10(suppl_J): J2 - J14. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Dudek, T. Rakowski, A. Dziewierz, and P. Kleczynski PCI after lytic therapy: when and how? Eur. Heart J. Suppl., December 1, 2008; 10(suppl_J): J15 - J20. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. R. Bates and B. K. Nallamothu Commentary: The Role of Percutaneous Coronary Intervention in ST-Segment-Elevation Myocardial Infarction Circulation, July 29, 2008; 118(5): 567 - 573. [Full Text] [PDF]
|
|
|
|
 |
|
 H. H. Ting, E. H. Bradley, Y. Wang, J. H. Lichtman, B. K. Nallamothu, M. D. Sullivan, B. J. Gersh, V. L. Roger, J. P. Curtis, and H. M. Krumholz Factors Associated With Longer Time From Symptom Onset to Hospital Presentation for Patients With ST-Elevation Myocardial Infarction Arch Intern Med, May 12, 2008; 168(9): 959 - 968. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A T Ratcliffe and C Pepper Thrombolysis or primary angioplasty? Reperfusion therapy for myocardial infarction in the UK Postgrad. Med. J., February 1, 2008; 84(988): 73 - 77. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Carstensen, G. C.I. Nelson, P. S. Hansen, L. Macken, S. Irons, M. Flynn, P. Kovoor, S. Y. Soo Hoo, M. R. Ward, and H. H. Rasmussen Field triage to primary angioplasty combined with emergency department bypass reduces treatment delays and is associated with improved outcome Eur. Heart J., October 1, 2007; 28(19): 2313 - 2319. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Dudek, T. Rakowski, A. Dziewierz, and W. Mielecki Time delay in primary angioplasty: how relevant is it? Heart, October 1, 2007; 93(10): 1164 - 1166. [Full Text] [PDF]
|
|
|
|
|
|
T. Siminiak and D. Dudek Fibrinolysis may widen the time window for primary angioplasty Eur. Heart J., April 2, 2007; 28(8): 915 - 917. [Full Text] [PDF]
|
|
|
|
 |
|
 C. S. Hollenbeak, J. P. Fitzgibbons, M. Rossi, D. L. Morris, and P. Stillman The Impact of Percutaneous Coronary Interventions on Outcomes for Acute Myocardial Infarction in Pennsylvania American Journal of Medical Quality, March 1, 2007; 22(2): 85 - 94. [Abstract] [PDF]
|
|
|
|
|
|
M Sejersten, Y Birnbaum, R S Ripa, C Maynard, G S Wagner, P Clemmensen, and for the DANAMI-2 Investigators Influences of electrocardiographic ischaemia grades and symptom duration on outcomes in patients with acute myocardial infarction treated with thrombolysis versus primary percutaneous coronary intervention: results from the DANAMI-2 trial Heart, November 1, 2006; 92(11): 1577 - 1582. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 U. Stenestrand, J. Lindback, L. Wallentin, and for the RIKS-HIA Registry Long-term outcome of primary percutaneous coronary intervention vs prehospital and in-hospital thrombolysis for patients with ST-elevation myocardial infarction. JAMA, October 11, 2006; 296(14): 1749 - 1756. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. George, G.-H. Yi, A. R. Schulman, B. T. Morrow, Y. Cheng, A. Gu, G. Zhang, M. C. Oz, D. Burkhoff, and J. Wang A polymerized bovine hemoglobin oxygen carrier preserves regional myocardial function and reduces infarct size after acute myocardial ischemia Am J Physiol Heart Circ Physiol, September 1, 2006; 291(3): H1126 - H1137. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Schomig, G. Ndrepepa, and A. Kastrati Late myocardial salvage: time to recognize its reality in the reperfusion therapy of acute myocardial infarction Eur. Heart J., August 2, 2006; 27(16): 1900 - 1907. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. A Ratner, R. Tzianetas, A. W Tu, J. L Johnson, M. Mackay, C. E Buller, M. Rowlands, and B. Reime Myocardial infarction symptom recognition by the lay public: the role of gender and ethnicity. J Epidemiol Community Health, July 1, 2006; 60(7): 606 - 615. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. L. McNamara, Y. Wang, J. Herrin, J. P. Curtis, E. H. Bradley, D. J. Magid, E. D. Peterson, M. Blaney, P. D. Frederick, H. M. Krumholz, et al. Effect of Door-to-Balloon Time on Mortality in Patients With ST-Segment Elevation Myocardial Infarction J. Am. Coll. Cardiol., June 6, 2006; 47(11): 2180 - 2186. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. D. Henry, J. M. Atkins, M. S. Cunningham, G. S. Francis, W. J. Groh, R. A. Hong, K. B. Kern, D. M. Larson, E. M. Ohman, J. P. Ornato, et al. ST-Segment Elevation Myocardial Infarction: Recommendations on Triage of Patients to Heart Attack Centers: Is it Time for a National Policy for the Treatment of ST-Segment Elevation Myocardial Infarction? J. Am. Coll. Cardiol., April 4, 2006; 47(7): 1339 - 1345. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Part 8: Stabilization of the Patient With Acute Coronary Syndromes Circulation, December 13, 2005; 112(24_suppl): IV-89 - IV-110. [Full Text] [PDF]
|
|
|
|
|
|
T. P. Wharton Jr, E. C. Keeley, C. L. Grines, T. P. Wharton Jr, E. C. Keeley, and C. L. Grines The Case for Community Hospital Angioplasty Circulation, November 29, 2005; 112(22): 3509 - 3534. [Full Text] [PDF]
|
|
|
|
|
|
Part 5: Acute Coronary Syndromes Circulation, November 29, 2005; 112(22_suppl): III-55 - III-72. [Full Text] [PDF]
|
|
|
|
|
|
R Zahn, A Vogt, U Zeymer, A K Gitt, K Seidl, M Gottwik, M A Weber, W Niederer, B Modl, H-J Engel, et al. In-hospital time to treatment of patients with acute ST elevation myocardial infarction treated with primary angioplasty: determinants and outcome. Results from the registry of percutaneous coronary interventions in acute myocardial infarction of the Arbeitsgemeinschaft Leitender Kardiologischer Krankenhausarzte Heart, August 1, 2005; 91(8): 1041 - 1046. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Schomig, J. Mehilli, D. Antoniucci, G. Ndrepepa, C. Markwardt, F. Di Pede, S. G. Nekolla, K. Schlotterbeck, H. Schuhlen, J. Pache, et al. Mechanical Reperfusion in Patients With Acute Myocardial Infarction Presenting More Than 12 Hours From Symptom Onset: A Randomized Controlled Trial JAMA, June 15, 2005; 293(23): 2865 - 2872. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H R Andersen, C J Terkelsen, L Thuesen, L R Krusell, S D Kristensen, H E Botker, J F Lassen, and T T Nielsen Myocardial infarction centres: the way forward Heart, June 1, 2005; 91(suppl_3): iii12 - iii15. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H.-K. Yip, C.-J. Wu, H.-W. Chang, C.-H. Yang, T.-H. Yu, Y.-H. Chen, and C.-L. Hang Prognostic Value of Circulating Levels of Endothelin-1 in Patients After Acute Myocardial Infarction Undergoing Primary Coronary Angioplasty Chest, May 1, 2005; 127(5): 1491 - 1497. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Authors/Task Force Members, S. Silber, P. Albertsson, F. F. Aviles, P. G. Camici, A. Colombo, C. Hamm, E. Jorgensen, J. Marco, J.-E. Nordrehaug, et al. Guidelines for Percutaneous Coronary Interventions: The Task Force for Percutaneous Coronary Interventions of the European Society of Cardiology Eur. Heart J., April 2, 2005; 26(8): 804 - 847. [Full Text] [PDF]
|
|
|
|
|
|
R. H. Mehta, C. B. Granger, K. P. Alexander, E. Bossone, H. D. White, and M. H. Sketch Jr Reperfusion strategies for acute myocardial infarction in the elderly: Benefits and risks J. Am. Coll. Cardiol., February 15, 2005; 45(4): 471 - 478. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S D Kristensen, H R Andersen, L Thuesen, L R Krusell, H E Botker, J F Lassen, and T T Nielsen Should patients with acute ST elevation MI be transferred for primary PCI? Heart, November 1, 2004; 90(11): 1358 - 1363. [Full Text] [PDF]
|
|
|
|
|
|
C. M. Gibson, S. A. Murphy, A. J. Kirtane, R. P. Giugliano, C. P. Cannon, E. M. Antman, E. Braunwald, and TIMI Study Group Association of duration of symptoms at presentation with angiographic and clinical outcomes after fibrinolytic therapy in patients with st-segment elevation myocardial infarction J. Am. Coll. Cardiol., September 1, 2004; 44(5): 980 - 987. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Menon, R. A. Harrington, J. S. Hochman, C. P. Cannon, S. D. Goodman, R. G. Wilcox, H. J. Schunemann, and E. M. Ohman Thrombolysis and Adjunctive Therapy in Acute Myocardial Infarction: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy Chest, September 1, 2004; 126(3_suppl): 549S - 575S. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. C. Keeley and C. L. Grines Primary Percutaneous Coronary Intervention for Every Patient with ST-Segment Elevation Myocardial Infarction: What Stands in the Way? Ann Intern Med, August 17, 2004; 141(4): 298 - 304. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. De Luca, A. W.J van't Hof, M.-J. de Boer, J. P. Ottervanger, J. C.A Hoorntje, A.T.M. Gosselink, J.-H. E Dambrink, F. Zijlstra, and H. Suryapranata Time-to-treatment significantly affects the extent of ST-segment resolution and myocardial blush in patients with acute myocardial infarction treated by primary angioplasty Eur. Heart J., June 2, 2004; 25(12): 1009 - 1013. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G Montalescot, H R Andersen, D Antoniucci, A Betriu, M J de Boer, L Grip, F J Neumann, and M T Rothman Recommendations on percutaneous coronary intervention for the reperfusion of acute ST elevation myocardial infarction Heart, June 1, 2004; 90(6): e37 - e37. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. De Luca, N. Ernst, F. Zijlstra, A. W. J. van't Hof, J. C. A. Hoorntje, J.-H. E. Dambrink, A. T. M. Gosslink, M.-J. de Boer, and H. Suryapranata Preprocedural TIMI flow and mortality in patients with acute myocardial infarction treated by primary angioplasty J. Am. Coll. Cardiol., April 21, 2004; 43(8): 1363 - 1367. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. C Petrie and F. Zijlstra Reflections on the Danish Revolution Eur. Heart J., April 1, 2004; 25(7): 540 - 542. [Full Text] [PDF]
|
|
|
|
|
|
G. De Luca, H. Suryapranata, J. P. Ottervanger, and E. M. Antman Time Delay to Treatment and Mortality in Primary Angioplasty for Acute Myocardial Infarction: Every Minute of Delay Counts Circulation, March 16, 2004; 109(10): 1223 - 1225. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. P. Giugliano and E. Braunwald Selecting the Best Reperfusion Strategy in ST-Elevation Myocardial Infarction: It's All a Matter of Time Circulation, December 9, 2003; 108(23): 2828 - 2830. [Full Text] [PDF]
|
|
|
|
|
|
P. G. Steg, E. Bonnefoy, S. Chabaud, F. Lapostolle, P.-Y. Dubien, P. Cristofini, A. Leizorovicz, P. Touboul, and for the Comparison of Angioplasty and Prehospital Impact of Time to Treatment on Mortality After Prehospital Fibrinolysis or Primary Angioplasty: Data From the CAPTIM Randomized Clinical Trial Circulation, December 9, 2003; 108(23): 2851 - 2856. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. D. Weaver All Hospitals Are Not Equal for Treatment of Patients With Acute Myocardial Infarction Circulation, October 14, 2003; 108(15): 1768 - 1771. [Full Text] [PDF]
|
|
|
|
|
|
G. De Luca, H. Suryapranata, F. Zijlstra, A. W. J. van't Hof, J. C. A. Hoorntje, A. T. M. Gosselink, J.-H. Dambrink, M.-J. de Boer, and ZWOLLE Myocardial Infarction Study Group Symptom-onset-to-balloon time and mortality in patients with acute myocardial infarction treated by primary angioplasty J. Am. Coll. Cardiol., September 17, 2003; 42(6): 991 - 997. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Schomig, G. Ndrepepa, J. Mehilli, M. Schwaiger, H. Schuhlen, S. Nekolla, J. Pache, S. Martinoff, H. Bollwein, and A. Kastrati Therapy-Dependent Influence of Time-to-Treatment Interval on Myocardial Salvage in Patients With Acute Myocardial Infarction Treated With Coronary Artery Stenting or Thrombolysis Circulation, September 2, 2003; 108(9): 1084 - 1088. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. K. Natarajan and S. Yusuf Primary angioplasty for ST-segment elevation myocardial infarction: Ready for prime time? Can. Med. Assoc. J., July 8, 2003; 169(1): 32 - 35. [Full Text] [PDF]
|
|
|
|
 |
|
 B. D Prendergast Prehospital thrombolysis BMJ, July 5, 2003; 327(7405): 1 - 2. [Full Text] [PDF]
|
|
|
|
 |
|
 J. P.S. Henriques, F. Zijlstra, M.-J. de Boer, A. W.J. van't Hof, A.T. M. Gosselink, J.-H. E. Dambrink, H. Suryapranata, and J. C.A. Hoorntje The prognostic importance of heart failure and age in patients treated with primary angioplasty Eur J Heart Fail, June 1, 2003; 5(3): 291 - 294. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. J. Topol and D. J. Kereiakes Regionalization of Care for Acute Ischemic Heart Disease: A Call for Specialized Centers Circulation, March 25, 2003; 107(11): 1463 - 1466. [Full Text] [PDF]
|
|
|
|
 |
|
 D. G Allen and X.-H. Xiao Role of the cardiac Na+/H+ exchanger during ischemia and reperfusion Cardiovasc Res, March 15, 2003; 57(4): 934 - 941. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F Zijlstra Angioplasty vs thrombolysis for acute myocardial infarction: a quantitative overview of the effects of interhospital transportation Eur. Heart J., January 1, 2003; 24(1): 21 - 23. [Full Text] [PDF]
|
|
|
|
|
|
P. Widimsky, T. Budesinsky, D. Vorac, L. Groch, M. Zelizko, M. Aschermann, M. Branny, J. St'asek, P. Formanek, and on behalf of the 'PRAGUE' Study Group Investigator Long distance transport for primary angioplasty vs immediate thrombolysis in acute myocardial infarction: Final results of the randomized national multicentre trial--PRAGUE-2 Eur. Heart J., January 1, 2003; 24(1): 94 - 104. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M Dalby and G Montalescot Transfer for primary angioplasty: who and how? Heart, December 1, 2002; 88(6): 570 - 572. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M.E. Bertrand and E.P. McFadden Late is perhaps not ... too late for primary PCI in acute myocardial infarction Eur. Heart J., August 1, 2002; 23(15): 1146 - 1148. [Full Text] [PDF]
|
|
|
|
 |
|
 Angioplasty Better than Fibrinolytic Therapy Regardless of Time of Presentation Journal Watch Emergency Medicine, July 17, 2002; 2002(717): 1 - 1. [Full Text]
|
|