Heart 1997;78:333-336 ( October )

Transferring patients for primary angioplasty: a retrospective analysis of 104 selected high risk patients with acute myocardial infarction

Felix Zijlstra, Arnoud W J van`t Hof, Ay Lee Liem, Jan C A Hoorntje, Harry Suryapranata, Menko-Jan de Boer

Department of Cardiology, Hospital De Weezenlanden, Groot Wezenland 20, 8011 JW Zwolle, The Netherlands

Correspondence to: Dr Zijlstra.

Accepted for publication 16 December 1996

ObjectiveTo investigate the feasibility of primary coronary angioplasty as a treatment option in patients with acute myocardial infarction after initial diagnosis in a local community hospital.
SettingReferral centre for interventional treatment of coronary artery disease.
MethodsDuring a five year period, 520 candidates for primary coronary angioplasty were treated in our institution, 104 after transfer from a community hospital. The transferred patients and the non-transferred patients (n = 416) were compared with regard to baseline clinical characteristics, time interval from symptom onset to treatment, and clinical outcome at six months.
ResultsIn this setting, the influence of transportation on total ischaemic time was limited, and there was no difference in clinical outcome between the transferred and the non-transferred patients. Clinical outcome was mainly dependent on the indication for transfer.
ConclusionsSafe and expedient transportation may facilitate the more widespread use of primary angioplasty in patients with acute myocardial infarction. A large randomised multicentre trial is needed to compare the relative merits of intravenous thrombolytic treatment in a local hospital with primary angioplasty after transfer in selected high risk patients with acute myocardial infarction.

Keywords: myocardial infarction;  coronary angioplasty;  reperfusion

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© 1997 by Heart
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