Interventional CardiologyImpact of prehospital delay on mortality in patients with acute myocardial infarction treated with primary angioplasty and intravenous thrombolysis☆,☆☆
Section snippets
Methods
The MITRA study and the MIR were German prospective, multicenter, observational studies of the current treatment of AMI. The MITRA study recruited patients between June 1994 and January 1997. Fifty-four hospitals, mainly located in the Southwest of Germany, including university hospitals, tertiary care centers, and smaller hospitals, participated in the study. The MIR study was a nationwide registry, which included patients from December 1996 to May 1998. A total of 217 hospitals, mainly
Results
From 1994 to 1998, 22,749 patients with AMI were registered by the MITRA and MIR registries. Primary angioplasty was performed in 1063 patients, and 7552 patients were treated with thrombolysis.
Selected patient characteristics for the different prehospital delays according to type of treatment are shown in Table I.
Discussion
The pooled data of the MITRA and MIR registries show that in patients with AMI treated with primary angioplasty, longer prehospital delays were followed by longer in-hospital times to treatment. Longer prehospital delays, and therefore longer times to treatment, were associated with a slightly decreasing mortality rate in patients treated with primary angioplasty. This is in contrast to the nonsignificantly increased mortality rate with increased prehospital delays in patients treated with
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Supported in part by AstraZeneca, Bristol Myers-Squibb, Ministerium für Gesundheit, Arbeit, Soziales des Landes Rheinland-Pfalz, Landesversicherungsanstalt Rheinland-Pfalz, Barmer, and Betriebskrankenkassen Rheinland-Pfalz.
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Reprint requests: Ralf Zahn, MD, Herzzentrum Ludwigshafen, Department of Cardiology; Bremserstrasse 79, D–67063 Ludwigshafen, Germany. E-mail: [email protected]