Early ST elevation myocardial infarction in non-capable percutaneous coronary intervention centres:in situfibrinolysis vs. percutaneous coronary intervention transfer

• DOI: 10.1093/eurheartj/ehv619
• Publication Date: 2016-01-11T21:05:37Z
• Authors: Xavier Carrillo; Eduard Fernandez-...; Oriol Rodriguez-Leor; Teresa Oliveras; Jordi Serra; Josepa Mauri; Antoni Curos; Ferran Rueda; Cosme García-García; Ricard Tresserras; Alba Rosas; Maria Teresa Faix...; Antoni Bayes-Genis
• Keywords: Codi IAM; Male; Patient Transfer; Fibrinolysis; Middle Aged; STEMI network; Time-to-Treatment; 3. Good health; STEMI; Hospitalization; 03 medical and health sciences; Percutaneous Coronary Intervention; 0302 clinical medicine; Spain; Humans; ST Elevation Myocardial Infarction; Female; Thrombolytic Therapy; Prospective Studies; Primary angioplasty; Retrospective Studies

The preferred reperfusion strategy for early ST elevation myocardial infarction (STEMI, defined as time from symptoms onset ≤120 min) in non-capable percutaneous coronary intervention (PCI) centres remains controversial. We sought to compare mortality of situ fibrinolysis vs. PCI transfer a real-life consecutive cohort STEMI.Prospective multicentre STEMI registry (Catalonia 'Codi IAM' network) all-comers centre with symptom first medical contact (FMC) <120 min. Two groups were identified: and PCI-capable centre. Primary endpoint was 30-day mortality. included 2470 patients, whom 2227 (90.2%) 243 (9.8%) comprised the groups, respectively. In group, diagnostic system delays shorter (24 31 min, P < 0.001; 45 119 0.001, respectively). Thirty-day 7.7 5.1% respectively (P = 0.09). However, patients group whose FMC-device achieved within 140 min associated significantly lower (2.0% <99 4.6% 99-140 min; 0.01 0.03, fibrinolysis). multivariable logistic regression analysis, an independent predictive factor (odds ratio: 1.91, 95% confidence interval: 1.01-3.50; 0.04), together age Killip-Kimball class (both 0.001).In assisted centres, had worse prognosis than patient transfer. Transfer seems recommended delay <140