Elias B. Hanna

Practical Cardiovascular Medicine


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myocardial infarction. J Am Coll Cardiol 2004; 44: 671–719.

      21 21. GUSTO-I Investigators. An international randomized trial comparing four thrombolytic strategies for acute myocardial infarction. N Engl J Med 1993; 329: 673–82.

      22 22. Ross AM, Coyne KS, Moreyra E, et al. Extended mortality benefit of early postinfarction reperfusion. GUSTO-I Angiographic Investigators. Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries Trial. Circulation 1998; 97: 1549. Outcomes of TIMI 2 flow intermediate between TIMI 0/1 and TIMI 3, but closer to TIMI 0/1.

      23 23. Lincoff AM, Topol EJ, Califf RM, et al. Significance of a coronary artery with thrombolysis in myocardial infarction grade 2 flow ‘patency’ (outcome in the Thrombolysis and Angioplasty in Myocardial Infarction trials). Am J Cardiol 1995; 75: 871–6. Intermediate outcomes for TIMI 2 flow (between TIMI 0/1 and TIMI 3).

      24 24. Reiner JS, Lundergan CF, Fung A, et al. Evolution of early TIMI 2 flow after thrombolysis for acute myocardial infarction. Circulation 1996; 94: 2441–6. If TIMI 2 flow persists, LV function/wall motion is as poor as TIMI 0–1 flow. IF TIMI 2 flow improves to TIMI 3 flow at 5–7 days, LV function improves, slightly less than TIMI 3 flow.

      25 25. Assessment of the Safety and Efficacy of a New Thrombolytic (ASSENT-2) Investigators.Single-bolus tenecteplase compared with front-loaded alteplase in acute myocardial infarction: the ASSENT-2 double-blind randomised trial. Lancet 1999; 354: 716–22.

      PCI vs. thrombolysis, DTB time

      1 26. Keeley EC, Boura JA, Grines CL. Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction: a quantitative review of 23 randomised trials. Lancet 2003; 361: 13–20.

      2 27. Andersen HR, Nielsen TT, Rasmussen K, et al. A comparison of coronary angioplasty with fibrinolytic therapy in acute myocardial infarction. N Engl J Med 2003; 349: 733–42. DANAMI-2 trial.

      3 28. Grines CL, Browne KF, Marco J, et al. A comparison of immediate angioplasty with thrombolytic therapy for acute myocardial infarction. The Primary Angioplasty in Myocardial Infarction Study Group. N Engl J Med 1993; 328: 673–9. PAMI trial.

      4 29. Widimský P, Budesínský T, Vorác D, et al. Long distance transport for primary angioplasty vs immediate thrombolysis in acute myocardial infarction. Final results of the randomized national multicentre trial: PRAGUE-2. Eur Heart J 2003; 24: 94–104.

      5 30. Steg PG, Bonnefoy E, Chabaud S, et al. Comparison of Angioplasty and Prehospital Thrombolysis in Acute Myocardial infarction (CAPTIM) Investigators. Impact of time to treatment on mortality after prehospital fibrinolysis or primary angioplasty: data from the CAPTIM randomized clinical trial. Circulation 2003; 108: 2851–6.

      6 31. Armstrong PW, Gershlick AH, Goldstein P, et al. Fibrinolysis or primary PCI in ST-segment elevation myocardial infarction. N Engl J Med 2013; 368: 1379–87. STREAM trial: PCI vs. TNK in patients presenting <3 h, with expected DTB >60 min (appears though that the mean PCI delay was ~78 min, i.e., not severely delayed, DTB close to 90 min). PCI and TNK were equivalent, trend toward less HF and shock with TNK, more bleeding in TNK (mainly if age >75). By design, most patients were randomized in the ambulance and transferred to PCI-capable hospital. Routine early PCI was performed in all TNK patients, at a median of 17 h.

      7 32. Pinto DS, Kirtane AJ, Nallamothu BK, et al. Hospital delays in reperfusion for ST-elevation myocardial infarction: implications when selecting a reperfusion strategy. Circulation 2006; 114: 2019–25.

      8 33. Boersma E. Primary Coronary Angioplasty vs Thrombolysis Group. Does time matter? A pooled analysis of randomized clinical trials comparing primary percutaneous coronary intervention and in-hospital fibrinolysis in acute myocardial infarction patients. Eur Heart J 2006; 27: 779–88.

      9 34. Brodie BR, Gersh BJ, Stuckey TD, et al. When is door-to-balloon time critical? Analysis From the HORIZONS-AMI (Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction) and CADILLAC (Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications) trials. J Am Coll Cardiol 2010; 56: 407–13.

      10 35. Brodie BR, Hansen C, Stuckey TD, et al. Door-to-balloon time with primary percutaneous coronary intervention for acute myocardial infarction impacts late cardiac mortality in high-risk patients and patients presenting early after the onset of symptoms J Am Coll Cardiol 2006; 47: 289–95.

      11 36. Rathore SS, Curtis JP, Chen J, et al. Association of door-to-balloon time and mortality in patients admitted to hospital with ST elevation myocardial infarc- tion: national cohort study. BMJ 2009; 338: b1807.

      12 37. Menees DS, Peterson ED, Wang Y, et al. Door-to-balloon time and mortality among patients undergoing primary PCI. N Engl J Med 2013; 369:901–909.

      13 38. Flynn A, Moscucci M, Share D, et al. Trends in door-to-balloon time and mortality in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention. Arch Intern Med 2010;170:1842-1849. No benefit from the reduction of DTB to <90 min over the years, in the last 2 references (national registries: first one is cathPCI registry, 2nd one is Michigan database). They compared years with better DTB to older years with longer DTB, and there was no difference in mortality. This is different from directly comparing DTB, which would be more subject to selection bias; in fact, DTB<90 min had lower mortality in the cathPCI paper, yet DTB improvement over the years did not improve mortality.

      14 39. Thiemann DR, Coresh J, Schulman SP, et al. Lack of benefit for intravenous thrombolysis in patients with myocardial infarction who are older than 75 years. Circulation 2000; 101: 2239–46.

      Combined PCI–thrombolysis. Management in non-PCI hospitals with expected PCI delays

      1 40. Hanna EB, Hennebry TA, Abu-fadel MS. Combined reperfusion strategies in patients with ST-segment elevation myocardial infarction: Rationale and cur- rent role. Clev Clin J Med 2010; 77: 629–39.

      2 41. Armstrong PW, Zheng Y, Westerhout CM, et al. Reduced dose tenecteplase and outcomes in elderly ST-segment elevation myocardial infarction patients: insights from the Strategic Reperfusion Early after Myocardial infarction trial. Am Heart J 2015; 169(6):890–898.

      3 42. Assessment of the Safety and Efficacy of a New Treatment Strategy with Percutaneous Coronary Intervention (ASSENT-4 PCI) investigators. Primary versus tenecteplase-facilitated percutaneous coronary intervention in patients with ST-segment elevation acute myocardial infarction (ASSENT-4 PCI): ran- domised trial. Lancet 2006; 367: 569–78.

      4 43. Ellis SG, Tendera M, de Belder MA, et al; FINESSE Investigators. Facilitated PCI in patients with ST-elevation myocardial infarction. N Engl J Med 2008; 358: 2205–17.

      5 44. Cantor WJ, Fitchett D, Borgundvaag B, et al; TRANSFER-AMI Trial Investigators. Routine early angioplasty after fibrinolysis for acute myocardial infarction. N Engl J Med 2009; 360: 2705–18.

      6 45. Di Mario C, Dudek D, Piscione F, et al; CARESS-in-AMI Investigators. Immediate angioplasty versus standard therapy with rescue angioplasty after throm- bolysis in the Combined Abciximab REteplase Stent Study in Acute Myocardial Infarction (CARESS-in-AMI): an open, prospective, randomised, multicentre trial. Lancet 2008; 371: 559–68.

      7 46. Bøhmer E, Hoffmann P, Abdelnoor M, Arnesen H, Halvorsen S. Efficacy and safety of immediate angioplasty versus ischemia-guided management after thrombolysis in acute myocardial infarction in areas with very long transfer distances results of the NORDISTEMI. J Am Coll Cardiol 2010; 55: 102–10.

      8 47. Carver A, Rafelt S, Gershlick AH, et al. Longer-term follow-up of patients recruited to the REACT (Rescue Angioplasty Versus Conservative Treatment or Repeat Thrombolysis) trial. J Am Coll Cardiol 2009; 54: 118–26.

      9 48. Henry TD, Sharkey SW, Burke MN, et al. A regional system to provide timely access to percutaneous coronary intervention for ST-elevation myocardial infarction. Circulation 2007; 116: 721–8.

      10 49. Danchin N, Coste P, Ferrières J, et al. FAST-MI Investigators. Comparison