Availability of on-site catheterization and clinical outcomes in patients receiving fibrinolysis for ST-elevation myocardial infarction

Aims To compare management and clinical outcomes in hospitals stratified by the availability of on-site catheterization in InTIME-II, a multicentre trial comparing alteplase with lanoteplase for acute myocardial infarction. Methods and Results We studied 15–078 patients enrolled in 35 countries and...

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Bibliographic Details
Published in:European heart journal 2001-11, Vol.22 (22), p.2104-2115
Main Authors: Llevadot, J, Giugliano, R.P, Antman, E.M, Wilcox, R.G, Gurfinkel, E.P, Henry, T, McCabe, C.H, Charlesworth, A, Thompson, S, Nicolau, J.C, Tebbe, U, Sadowski, Z, Braunwald for the InTIME (intraenous nPA for Treatment of Infarcting Myocardium Early) II Invatigators, E
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
availability of on-site catheterization
Cardiac Catheterization
Cardiac Surgical Procedures
Coronary Angiography
Data Collection
Double-Blind Method
Electrocardiography
Female
fibrinolysis
Fibrinolytic Agents - therapeutic use
Follow-Up Studies
Health Services Accessibility
Humans
Male
Middle Aged
Myocardial infarction
Myocardial Infarction - mortality
Myocardial Infarction - therapy
Myocardial Revascularization
outcomes
Patient Admission
Risk Factors
Survival Analysis
Treatment Outcome
United Kingdom - epidemiology
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Summary:Aims To compare management and clinical outcomes in hospitals stratified by the availability of on-site catheterization in InTIME-II, a multicentre trial comparing alteplase with lanoteplase for acute myocardial infarction. Methods and Results We studied 15–078 patients enrolled in 35 countries and 855 hospitals. Thirty-one percent of hospitals had 24-h, 25% day-only, and 44% no on-site catheterization facilities. Rates of cardiac angiography (57%, 38%, 26%) and revascularization (37%, 21%, 17%) were higher in hospitals with increasing access to on-site facilities ) Conclusions There is a marked variation in procedure use by the availability of on-site catheterization with no major differences in patient outcomes. There is a need for additional randomized trials in the current era to address both the appropriate selection of patients and timing of invasive procedures in ST-elevation acute myocardial infarction.
ISSN:0195-668X
1522-9645
DOI:10.1053/euhj.2001.2622