Spectrum of reperfusion strategies and factors influencing the use of primary angioplasty in patients with acute myocardial infarction admitted to hospitals with the facilities to perform primary angioplasty
R Zahna, R Schielea, K Seidla, K E Hauptmannb, T Voigtländerc, H-J Rupprechtc, M Gottwikd, H G Glunze, J Sengesa, for the Maximal Individual Therapy in Acute Myocardial Infarction (MITRA) Study Group
a Herzzentrum
Ludwigshafen, Department of Cardiology, Bremserstra
e 79, D-67063
Ludwigshafen, Germany, b Innere Medizin, Abt. für
Kardiologie, Krankenhaus der Barmherzigen Brüder, Trier, Germany, c II Med. Klinik, Johannes
Gutenberg Universität, Mainz, Germany, d Med.
Klinik 8-Kardiologie, Klinikum Nürnberg Süd, Germany, e Abteilung für Kardiologie,
Westpfalzklinikum, Kaiserslautern, Germany
Correspondence to: Dr Zahn.
Accepted for publication 19 March 1999
OBJECTIVE
To determine
the frequency of the use of primary angioplasty in patients with acute
myocardial infarction and the factors influencing its indications in
hospitals with the facilities to perform this treatment.
DESIGNData from the
maximal individual therapy in acute myocardial infarction (MITRA) trial
were analysed, concerning the effects of the decisions of individual
hospitals, the time of admission of patients, and the effects of
patient characteristics on the selection of reperfusion treatment.
PATIENTSBetween June
1994 and January 1997 eight hospitals treated 1532 patients with acute
myocardial infarction. 418 (27.3%) were treated conservatively, 641 (41.8%) were treated using intravenous thrombolysis, 387 (25.3%) were
treated using primary angioplasty, and 86 (5.6%) received a
combination of thrombolysis and angioplasty.
RESULTSThe
proportion of patients treated with primary angioplasty varied from
1.8% to 57.7% among the eight hospitals. The use of primary
angioplasty during non-office hours also showed wide variation, ranging
from 20% to 54% between centres. The use of thrombolysis was
comparatively evenly distributed during the non-office hours, ranging
from 50-69%. Four hospitals with a primary angioplasty use rate
> 30% showed no difference in the proportion of patients with
contraindications for thrombolysis, high risk patients, or a
combination of both, when compared with four hospitals with a lower
rate of primary angioplasty use (98/322 (30.4%)
v 19/65 (29.2%), respectively,
p = 0.847).
CONCLUSIONSIn
hospitals with the facilities for performing primary angioplasty the
most important factors influencing its use were the discretion of the
individual hospital and the time of patient admission. Characteristics
of patients did not influence the choice of reperfusion treatment
Keywords: acute myocardial infarction; primary angioplasty; reperfusion treatment
© 1999 by Heart
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
This article has been cited by other articles:
-
Zahn, R., Schiele, R., Schneider, S., Gitt, A. K., Wienbergen, H., Seidl, K., Voigtlander, T., Gottwik, M., Berg, G., Altmann, E., Rosahl, W., Senges, J., for the Maximal Individual Therapy in Acute Myocar,
(2001). Primary angioplasty versus intravenous thrombolysis in acute myocardial infarction: can we define subgroups of patients benefiting most from primary angioplasty?: Results from the pooled data of the maximal individual therapy in acute myocardial infarction registry and the myocardial infarction registry. J Am Coll Cardiol
37: 1827-1835
[Abstract] [Full Text] -
BRENER, S, TOPOL, E J
(1999). Logic and logistics: conundrum in reperfusion treatment for acute myocardial infarction. Heart
82: 402-403
[Full Text]
- Full Text
- Full Text (PDF)
- Submit a response
- Alert me when this article is cited
- Alert me when eLetters are posted
- Alert me if a correction is posted
- Citation Map
Services
- Email this link to a friend
- Similar articles in this journal
- Similar articles in PubMed
- Add article to my folders
- Download to citation manager
- Request Permissions
Citing Articles
Google Scholar
PubMed
Topic Collections
-
Interventional cardiology
-
Clinical diagnostic tests
-
Drugs: cardiovascular system
- Acute coronary syndromes
Bookmark with
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
