Skip Navigation


European Heart Journal Advance Access originally published online on June 9, 2005
European Heart Journal 2005 26(16):1684-1685; doi:10.1093/eurheartj/ehi362
This Article
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
26/16/1684-a    most recent
ehi362v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by Adgey, A.A. J.
Right arrow Articles by McClelland, A. J.J.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Adgey, A.A. J.
Right arrow Articles by McClelland, A. J.J.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The European Society of Cardiology 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oupjournals.org

Percutaneous coronary intervention and 1-year survival in patients treated with fibrinolytic therapy for acute ST-elevation myocardial infarction: reply

A.A. Jennifer Adgey

Regional Medical Cardiology Centre
Royal Victoria Hospital
Grosvenor Road
Belfast BT12 6BA
Northern Ireland
UK
Tel: +44 2890 632171
E-mail address:
jennifer.adgey{at}royalhospitals.n-i.nhs.uk

Anthony J.J. McClelland

Regional Medical Cardiology Centre
Royal Victoria Hospital
Grosvenor Road
Belfast BT12 6BA
Northern Ireland
UK

We acknowledge the interest of Faizel Osman et al. in our manuscript.1 They point out that the patients receiving in-hospital PCI had a significantly shorter pain to needle time [2.5 (1.7–4.0) vs. 3.9 (2.2–5.5)].1 The more likely mode of admission via the mobile coronary care unit was seen in the PCI group. However, both these factors were included in the multiple logistic regression model and, therefore, their influence on the effects of PCI on mortality has been adjusted for.

The observation by Danchin2 that patients in the PCI group were survivors at least until the time PCI was performed was a limitation of our study. One way to avoid this would have been to include only those patients surviving to day 14, a method used by Stenestrand and Wallentin3 in their study. Another solution would be to include only those patients who survived until the day of the latest PCI. This can result in the effects of PCI on mortality in the early period being missed. However, when we employed the latter method in our study, the mortality in the PCI group remains significantly smaller than in the non-PCI group (4 vs. 9%, P=0.03).

Finally, in the PCI group 37 (24%) patients received glycoprotein IIbIIIa inhibitors.

As we have indicated, this observational study cannot adjust for all confounders but it lends support to the need for further studies regarding the optimal strategy for treating patients with ST-elevation myocardial infarction.

References

  1. McClelland AJJ, Owens CG, Walsh SJ, McCarty D, Mathew T, Stevenson M, Gracey H, Khan MM, Adgey AAJ. Percutaneous coronary intervention and 1 year survival in patients treated with fibrinolytic therapy for acute ST-elevation myocardial infarction. Eur Heart J 2005;26:544–548.[Abstract/Free Full Text]
  2. Danchin N. Percutaneous coronary intervention following intravenous fibrinolytic therapy: should it be a must? Eur Heart J 2005;26:529–531.[Free Full Text]
  3. Stenestrand U, Wallentin L. Early revascularisation and 1-year survival in 14-day survivors of acute myocardial infarction: a prospective cohort study. Lancet 2002;359:1805–1811.[CrossRef][ISI][Medline]

Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?



This Article
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
26/16/1684-a    most recent
ehi362v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by Adgey, A.A. J.
Right arrow Articles by McClelland, A. J.J.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Adgey, A.A. J.
Right arrow Articles by McClelland, A. J.J.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?