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European Heart Journal 2003 24(20):1898; doi:10.1016/j.ehj.2003.06.007
Copyright © 2003 by the European Society of Cardiology.
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A reply

Reply to letter to the editor

F Zijlstra*

Academic Hospital Groningen, Department of Cardiology, Hanzplein 1, Postbus 30.001, 9700 Groningen, RB, Netherlands

* Corresponding author. Tel.: +31-50-3612355; fax: +31-50-3611347
E-mail address: f.zijlstra{at}thorax.azg.nl

In the january 2003 issue of the European Heart Journal the final results of the randomized national multicentre trial called PRAGUE-2,long distance transport for primary angioplasty versus immediate thrombolysis in acute myocardial infarction were reported bij Dr P. Widimsky et al.In the editorial that accompanies this important paper I have attempted to give, within the constrains of an editorial,an overview of the present knowledge with regard to the impact of interhospital transportation on the relative outcome after primary angioplasty compared to lytic therapy for acute myocardial infarction.The pooled data show that outcome after primary angioplasty is better compared to lytic therapy irrespective of the need for additional transportation.With regard to the remarks of Dr Thieme it should be kept in mind that:

  1. A pooled analysis is not a meta-analysis,nor thus it pretend to beone
  2. There is no reason to exclude the data from Weaver et al.
  3. A previous infarction is not associated with better outcome
  4. ASSENT-3 and AMI-SK do not compare primary angioplasty and lytic therapy
  5. My conclusion is as solid as a rock: The PRAGUE-2 and DANAMI-2 trials areespecially important as they show that primary angioplasty therapy for acute myocardial infarction can be applied in large areas of partly urbanized Europe with good results.


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