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THE IMPACT OF GENDER ON OUTCOMES OF PATIENTS WITH ST ELEVATION MYOCARDIAL INFARCTION TRANSPORTED FOR PERCUTANEOUS CORONARY INTERVENTION: ANALYSIS OF THE PRAGUE-1 AND 2 STUDIES

Motovska Z, Widimsky P, Aschermann M, on behalf of The PRAGUE Study Group Investigators

PRAGUE-1 and PRAGUE-2 trials compared onsite thrombolysis in community hospitals without a catheterisation laboratory with immediate PCI (long-distance) transport to a cardiac centre. In this sub-study, the impact of gender on 30-day mortality was assessed. The mortality of women treated with onsite thrombolysis was nearly twice as high as those women transported for PCI. The authors conclude that long-distance transport for women with STEMI from a community hospital to a tertiary PCI centre is a significantly more cost-effective strategy than onsite thrombolysis.

For full version go to: Heart 2008;94:e5. http://heart.bmj.com/cgi/content/full/94/3/e5

RISK STRATIFICATION IN ST-ELEVATION MYOCARDIAL INFARCTION IS ENHANCED BY COMBINING BASELINE ST DEVIATION AND SUBSEQUENT ST SEGMENT RESOLUTION

Toma M, Fu Y, Wagner G, Goodman SG, Granger C, Wallentin L, Van de Werf F, Armstrong P

This study assessed the prognostic impact of ST resolution after fibrinolysis and influence of baseline ST deviation in the ASSENT 3 trial that included 4565 patients. At 180-minute post-fibrinolysis, patients with complete ST resolution had lower 30-day and 1-year mortality compared with those with incomplete resolution. However, after multi-variable adjustment anterior MI, patients with the greatest (highest quartile) baseline sum of ST deviation had a greater 30-day and 1-year mortality than those in the lowest quartile in both complete and incomplete ST resolution groups. In contrast, in inferior MI patients this pattern only existed when ST resolution was incomplete. These findings indicate that the percentage of ST resolution alone is an incomplete guide to …

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