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Titolo:
Availability of on-site catheterization and clinical outcomes in patients receiving fibrinolysis for ST-elevation myocardial infarction
Autore:
Llevadot, J; Giugliano, RP; Antman, EM; Wilcox, RG; Gurfinkel, EP; Henry, T; McCabe, CH; Charlesworth, A; Thompson, S; Nicolau, JC; Tebbe, U; Sadowski, Z; Braunwald, E;
Indirizzi:
Brigham & Womens Hosp, Div Cardiovasc, TIMI Study Grp, Boston, MA 02115 USA Brigham & Womens Hosp Boston MA USA 02115 Study Grp, Boston, MA 02115 USA Harvard Univ, Sch Med, Boston, MA USA Harvard Univ Boston MA USAHarvard Univ, Sch Med, Boston, MA USA Queens Med Ctr, Div Cardiovasc Med, Nottingham NG7 2UH, England Queens MedCtr Nottingham England NG7 2UH d, Nottingham NG7 2UH, England Fdn Favaloro, Buenos Aires, DF, Argentina Fdn Favaloro Buenos Aires DF Argentina loro, Buenos Aires, DF, Argentina Hennepin Cty Med Ctr, Minneapolis, MN 55415 USA Hennepin Cty Med Ctr Minneapolis MN USA 55415 , Minneapolis, MN 55415 USA Nottingham Clin Res Grp, Nottingham, England Nottingham Clin Res Grp Nottingham England Res Grp, Nottingham, England Inst Coracao, Sao Paulo, Brazil Inst Coracao Sao Paulo BrazilInst Coracao, Sao Paulo, Brazil Klinikum Lippe Detmold, Detmold, Germany Klinikum Lippe Detmold Detmold Germany Lippe Detmold, Detmold, Germany Klin Choroby Wiencowej, Warsaw, Poland Klin Choroby Wiencowej Warsaw Poland Choroby Wiencowej, Warsaw, Poland
Titolo Testata:
EUROPEAN HEART JOURNAL
fascicolo: 22, volume: 22, anno: 2001,
pagine: 2104 - 2115
SICI:
0195-668X(200111)22:22<2104:AOOCAC>2.0.ZU;2-R
Fonte:
ISI
Lingua:
ENG
Soggetto:
CORONARY-ANGIOGRAPHY; UNITED-STATES; CARDIAC PROCEDURES; CARDIOGENIC-SHOCK; EARLY REVASCULARIZATION; SUCCESSFUL THROMBOLYSIS; II-TRIAL; HOSPITALS; FACILITIES; MANAGEMENT;
Keywords:
myocardial infarction; fibrinolysis; availability of on-site catheterization; outcomes;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
41
Recensione:
Indirizzi per estratti:
Indirizzo: Giugliano, RP TIMI Study Off, 333 Longwood Ave,Suite 402, Boston, MA 02115USA TIMI Study Off 333 Longwood Ave,Suite 402 Boston MA USA 02115
Citazione:
J. Llevadot et al., "Availability of on-site catheterization and clinical outcomes in patients receiving fibrinolysis for ST-elevation myocardial infarction", EUR HEART J, 22(22), 2001, pp. 2104-2115

Abstract

Aims To compare management and clinical outcomes in hospitals stratified by the availability or 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 (P <0.0001). The presence of a 24-h on-site facility was the strongest predictor of angiography duringthe index admission (odds ratio 4.17, 95% CI 3.85-4.54). There were no major differences in patient outcomes at 30 days when hospitals were stratified by availability of on-site catheterization. Adjusted 1-year mortality wassimilar between groups of hospitals (odds ratio for day-only 0.94 [0.80-1.09] and odds ratio for no availability 0.95 [0.83-1.10] compared to hospitals with 24-h 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. (C) 2001 The European Society of Cardiology.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 21/01/20 alle ore 07:19:37