PMID- 17445011
OWN - NLM
STAT- MEDLINE
DCOM- 20070702
LR  - 20101118
IS  - 1445-5994 (Electronic)
IS  - 1444-0903 (Linking)
VI  - 37
IP  - 7
DP  - 2007 Jul
TI  - Results of primary percutaneous coronary intervention in a consecutive group of 
      patients with acute ST elevation myocardial infarction at a tertiary Australian 
      centre.
PG  - 464-71
AB  - BACKGROUND: Multicentre randomized controlled trials (RCT) of primary 
      percutaneous coronary intervention (PCI) for ST elevation myocardial infarction 
      (STEMI) have consistently shown lower mortality compared with fibrinolysis, if 
      carried out in a timely manner. Although primary PCI is now standard of care in 
      many centres, it remains unknown whether results from RCT of selected patients 
      are generalizable to a 'real-world' Australian setting. The primary goal of this 
      study was to evaluate whether a strategy of routine invasive management for 
      patients with STEMI can achieve 30-day and 12-month mortality rates comparable 
      with multicentre RCT. Secondary goals were to determine 30-day mortality rates in 
      prespecified high-risk subgroups, and symptom-onset- and 
      door-to-balloon-inflation times. METHODS: A retrospective observational study of 
      189 consecutive patients treated with primary PCI for STEMI in a single 
      Australian centre performing PCI for acute STEMI. RESULTS: All-cause mortality 
      was 6.9% at 30 days, and 10.4% at 12 months. Mortality in patients presenting 
      without cardiogenic shock was low (2.4% at 30 days; 5.0% at 12 months), whereas 
      12-month mortality in patients with shock was higher, particularly in the elderly 
      (29.4% for patients <75 years; 85.7% for patients > or =75 years, P = 0.01). 
      Symptom-onset-to-balloon-inflation time was < or =4 h in 56% of patients (median 
      231 min); however, a door-to-balloon time of <90 min was achieved in only 20% 
      (median 133 min). CONCLUSION: Mortality and symptom-onset-to-balloon-inflation 
      times reported in RCT of primary PCI for STEMI are generalizable to 'real-world' 
      Australian practice; however, further efforts to reduce door-to-balloon times are 
      required.
FAU - van Gaal, W J
AU  - van Gaal WJ
AD  - Department of Cardiology, The John Radcliffe, Oxford, United Kingdom. 
      bill.vangaal@conted.ox.ac.uk
FAU - Clark, D
AU  - Clark D
FAU - Barlis, P
AU  - Barlis P
FAU - Lim, C C S
AU  - Lim CC
FAU - Johns, J
AU  - Johns J
FAU - Horrigan, M
AU  - Horrigan M
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20070416
PL  - Australia
TA  - Intern Med J
JT  - Internal medicine journal
JID - 101092952
SB  - IM
MH  - Aged
MH  - *Angioplasty, Balloon, Coronary
MH  - Australia
MH  - Electrocardiography
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Multicenter Studies as Topic
MH  - Myocardial Infarction/diagnosis/*mortality/*therapy
MH  - Thrombolytic Therapy/*mortality
MH  - Treatment Outcome
EDAT- 2007/04/21 09:00
MHDA- 2007/07/03 09:00
CRDT- 2007/04/21 09:00
PHST- 2007/04/21 09:00 [pubmed]
PHST- 2007/07/03 09:00 [medline]
PHST- 2007/04/21 09:00 [entrez]
AID - IMJ1357 [pii]
AID - 10.1111/j.1445-5994.2007.01357.x [doi]
PST - ppublish
SO  - Intern Med J. 2007 Jul;37(7):464-71. doi: 10.1111/j.1445-5994.2007.01357.x. Epub 
      2007 Apr 16.