Multicentre randomized trial comparing transport to primary angioplasty vs immediate thrombolysis vs combined strategy for patients with acute myocardial infarction presenting to a community hospital without a catheterization laboratory. The PRAGUE study
Jazyk angličtina Země Velká Británie, Anglie Médium print
Typ dokumentu klinické zkoušky, srovnávací studie, časopisecké články, multicentrická studie, randomizované kontrolované studie
PubMed
10781354
DOI
10.1053/euhj.1999.1993
PII: S0195668X99919930
Knihovny.cz E-zdroje
- MeSH
- balónková koronární angioplastika * MeSH
- infarkt myokardu terapie MeSH
- komunitní nemocnice MeSH
- lidé středního věku MeSH
- lidé MeSH
- přemístění pacientů * MeSH
- senioři MeSH
- studie proveditelnosti MeSH
- trombolytická terapie * MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky MeSH
- multicentrická studie MeSH
- randomizované kontrolované studie MeSH
- srovnávací studie MeSH
- Geografické názvy
- Česká republika MeSH
BACKGROUND: Primary coronary angioplasty is an effective reperfusion strategy in acute myocardial infarction. However, its availability is limited, and transporting patients to an angioplasty centre in the acute phase of myocardial infarction has not yet been proved safe. METHODS: The PRAGUE study (PRimary Angioplasty in patients transferred from General community hospitals to specialized PTCA Units with or without Emergency thrombolysis) compared three reperfusion strategies in patients with acute myocardial infarction, presenting within 6 h of symptom onset at community hospitals without a catheterization laboratory: group A - thrombolytic therapy in community hospitals (n=99), group B - thrombolytic therapy during transportation to angioplasty (n=100), group C - immediate transportation for primary angioplasty without pre-treatment with thrombolysis (n=101). RESULTS: No complications occurred during transportation in group C. Two ventricular fibrillations occurred during transportation in group B. Median admission-reperfusion time in transported patients (group B 106 min, group C 96 min) compared favourably with the anticipated >90 min in group A. The combined primary end-point (death/reinfarction/stroke at 30 days) was less frequent in group C (8%) compared to groups B (15%) and A (23%, P<0. 02). The incidence of reinfarction was markedly reduced by transport to primary angioplasty (1% in group C vs 7% in group B vs 10% in group A, P<0.03). CONCLUSIONS: Transferring patients from community hospitals to a tertiary angioplasty centre in the acute phase of myocardial infarction is feasible and safe. This strategy is associated with a significant reduction in the incidence of reinfarction and the combined clinical end-point of death/reinfarction/stroke at 30 days when compared to standard thrombolytic therapy at the community hospital.
Citace poskytuje Crossref.org
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