PMID- 15831596
OWN - NLM
STAT- MEDLINE
DCOM- 20060203
LR  - 20181113
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Print)
IS  - 1355-6037 (Linking)
VI  - 92
IP  - 1
DP  - 2006 Jan
TI  - Primary percutaneous coronary intervention versus thrombolytic treatment: long 
      term follow up according to infarct location.
PG  - 75-9
AB  - OBJECTIVES: To study the clinical significance of infarct location during long 
      term follow up in a trial comparing thrombolysis with primary angioplasty. 
      DESIGN: Retrospective longitudinal cohort analysis of prospectively entered data. 
      SETTING: Patients with acute ST elevation myocardial infarction (STEMI) treated 
      with primary percutaneous coronary intervention (PCI). PATIENTS: In the Zwolle 
      trial 395 patients with acute STEMI were randomly assigned to intravenous 
      streptokinase or PCI. MAIN OUTCOME MEASURES: Survival according to infarct 
      location and treatment after 8 (2) years of follow up. RESULTS: 105 patients 
      died: 63 patients in the streptokinase group and 42 patients in the primary PCI 
      group (relative risk (RR) 1.6, 95% confidence interval (CI) 1.0 to 2.6; p = 
      0.03). In patients with non-anterior STEMI there was no difference in mortality 
      between streptokinase and PCI treated patients (RR 1.1, 95% CI 0.6 to 2.1; p = 
      0.68) but the streptokinase group had significantly more major adverse cardiac 
      events (MACE) than the PCI group (RR 2.1, 95% CI 1.2 to 3.6). The number needed 
      to treat to prevent one MACE was four. In patients with anterior STEMI, mortality 
      was higher in the streptokinase group than in the PCI group (RR 2.7, 95% CI 1.4 
      to 5.5; p = 0.004). The number needed to treat to prevent one death was five. 
      Kaplan-Meier analysis confirmed the benefits of primary angioplasty in the first 
      year and showed additional benefit of PCI compared with streptokinase between 1-8 
      years after the acute event. CONCLUSIONS: Patients with anterior STEMI have 
      better long term survival when treated with PCI than with streptokinase. In 
      patients alive one year after the acute event, PCI confers a significant 
      additional survival benefit, probably due to better preserved residual left 
      ventricular function.
FAU - Henriques, J P S
AU  - Henriques JP
AD  - Department of Cardiology, Isala Klinieken, locatie Weezenlanden, Zwolle, The 
      Netherlands.
FAU - Zijlstra, F
AU  - Zijlstra F
FAU - van 't Hof, A W J
AU  - van 't Hof AW
FAU - de Boer, M-J
AU  - de Boer MJ
FAU - Dambrink, J-H E
AU  - Dambrink JH
FAU - Gosselink, A T M
AU  - Gosselink AT
FAU - Hoorntje, J C A
AU  - Hoorntje JC
FAU - Ottervanger, J P
AU  - Ottervanger JP
FAU - Suryapranata, H
AU  - Suryapranata H
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20050414
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
RN  - 0 (Fibrinolytic Agents)
RN  - EC 3.4.- (Streptokinase)
SB  - IM
MH  - Aged
MH  - Angioplasty, Balloon, Coronary/*methods
MH  - Epidemiologic Methods
MH  - Female
MH  - Fibrinolytic Agents/*therapeutic use
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/physiopathology/*therapy
MH  - Recurrence
MH  - Streptokinase/*therapeutic use
MH  - Stroke Volume/physiology
MH  - Survival Analysis
MH  - Thrombolytic Therapy/*methods
MH  - Ventricular Dysfunction, Left/physiopathology
PMC - PMC1860964
COIS- No conflicts of interest
EDAT- 2005/04/16 09:00
MHDA- 2006/02/04 09:00
PMCR- 2009/01/01
CRDT- 2005/04/16 09:00
PHST- 2005/04/16 09:00 [pubmed]
PHST- 2006/02/04 09:00 [medline]
PHST- 2005/04/16 09:00 [entrez]
PHST- 2009/01/01 00:00 [pmc-release]
AID - hrt.2005.060152 [pii]
AID - ht60152 [pii]
AID - 10.1136/hrt.2005.060152 [doi]
PST - ppublish
SO  - Heart. 2006 Jan;92(1):75-9. doi: 10.1136/hrt.2005.060152. Epub 2005 Apr 14.