A randomized trial of transfer for primary angioplasty versus on-site thrombolysis in patients with high-risk myocardial infarction: the Air Primary Angioplasty in Myocardial Infarction study

• Published in: Journal of the American College of Cardiology 2002-06, Vol.39 (11), p.1713-1719
• Main Authors: Grines, Cindy L, Westerhausen, Jr, Donald R, Grines, Lorelei L, Hanlon, J Timothy, Logemann, Timothy L, Niemela, Matti, Weaver, W Douglas, Graham, Marianne, Boura, Judith, O'Neill, William W, Balestrini, Carlos
• Format: Article
• Language: English
• Subjects: Aged; Angioplasty; Angioplasty, Balloon, Coronary; Cardiology; Clinical outcomes; Coronary vessels; Drug Therapy, Combination; Female; Fibrinolytic Agents - therapeutic use; Heart attacks; Humans; Length of Stay - statistics & numerical data; Male; Middle Aged; Mortality; Myocardial Infarction - complications; Myocardial Infarction - drug therapy; Myocardial Infarction - mortality; Myocardial Infarction - therapy; Patient Transfer; Risk Factors; Streptokinase - therapeutic use; Thrombolytic Therapy; Time Factors; Tissue Plasminogen Activator - therapeutic use; Treatment Outcome
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/S0735-1097(02)01870-3

The Air Primary Angioplasty in Myocardial Infarction (PAMI) study was designed to determine the best reperfusion strategy for patients with high-risk acute myocardial infarction (AMI) at hospitals without percutaneous transluminal coronary angioplasty (PTCA) capability. Previous studies have suggested that high-risk patients have better outcomes with primary PTCA than with thrombolytic therapy. It is unknown whether this advantage would be lost if the patient had to be transferred for PTCA, and reperfusion was delayed. Patients with high-risk AMI (age >70 years, anterior MI, Killip class II/III, heart rate >100 beats/min or systolic BP