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Impact of prehospital thrombolysis for acute myocardial infarction on 1-year outcome: results from the French Nationwide USIC 2000 Registry.
Circulation. 2004 Oct 05; 110(14):1909-15.Circ

Abstract

BACKGROUND

Limited data are available on the impact of prehospital thrombolysis (PHT) in the "real-world" setting.

METHODS AND RESULTS

Of 443 intensive care units in France, 369 (83%) prospectively collected all cases of infarction (< or =48 hours of symptom onset) in November 2000; 1922 patients (median age, 67 years; 73% men) with ST-segment-elevation infarction were included, of whom 180 (9%) received intravenous thrombolysis before hospital admission (PHT). Patients with PHT were younger than those with in-hospital thrombolysis, primary percutaneous interventions, or no reperfusion therapy. Median time from symptom onset to hospital admission was 3.6 hours for PHT, 3.5 hours for in-hospital lysis, 3.2 hours for primary percutaneous interventions, and 12 hours for no reperfusion therapy. In-hospital death was 3.3% for PHT, 8.0% for in-hospital lysis, 6.7% for primary percutaneous interventions, and 12.2% for no reperfusion therapy. One-year survival was 94%, 89%, 89%, and 79%, respectively. In a multivariate analysis of predictors of 1-year survival, PHT was associated with a 0.49 relative risk of death (95% CI, 0.24 to 1.00; P=0.05). When the analysis was limited to patients receiving reperfusion therapy, the relative risk of death for PHT was 0.52 (95% CI, 0.25 to 1.08; P=0.08). In patients with PHT admitted in < or =3.5 hours, in-hospital mortality was 0% and 1-year survival was 99%.

CONCLUSIONS

The 1-year outcome of patients treated with PHT compares favorably with that of patients treated with other modes of reperfusion therapy; this favorable trend persists after multivariate adjustment. Patients with PHT admitted very early have a very high 1-year survival rate.

Authors+Show Affiliations

Service de Cardiologie, Hôpital Européen Georges Pompidou, 20 Rue Leblanc, 75015 Paris, France. nicolas.danchin@egp.ap-hop-paris.fr.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15451803

Citation

Danchin, Nicolas, et al. "Impact of Prehospital Thrombolysis for Acute Myocardial Infarction On 1-year Outcome: Results From the French Nationwide USIC 2000 Registry." Circulation, vol. 110, no. 14, 2004, pp. 1909-15.
Danchin N, Blanchard D, Steg PG, et al. Impact of prehospital thrombolysis for acute myocardial infarction on 1-year outcome: results from the French Nationwide USIC 2000 Registry. Circulation. 2004;110(14):1909-15.
Danchin, N., Blanchard, D., Steg, P. G., Sauval, P., Hanania, G., Goldstein, P., Cambou, J. P., Guéret, P., Vaur, L., Boutalbi, Y., Genès, N., & Lablanche, J. M. (2004). Impact of prehospital thrombolysis for acute myocardial infarction on 1-year outcome: results from the French Nationwide USIC 2000 Registry. Circulation, 110(14), 1909-15.
Danchin N, et al. Impact of Prehospital Thrombolysis for Acute Myocardial Infarction On 1-year Outcome: Results From the French Nationwide USIC 2000 Registry. Circulation. 2004 Oct 5;110(14):1909-15. PubMed PMID: 15451803.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of prehospital thrombolysis for acute myocardial infarction on 1-year outcome: results from the French Nationwide USIC 2000 Registry. AU - Danchin,Nicolas, AU - Blanchard,Didier, AU - Steg,Philippe Gabriel, AU - Sauval,Patrick, AU - Hanania,Guy, AU - Goldstein,Patrick, AU - Cambou,Jean-Pierre, AU - Guéret,Pascal, AU - Vaur,Laurent, AU - Boutalbi,Youcef, AU - Genès,Nathalie, AU - Lablanche,Jean-Marc, AU - ,, Y1 - 2004/09/27/ PY - 2004/9/29/pubmed PY - 2005/5/28/medline PY - 2004/9/29/entrez SP - 1909 EP - 15 JF - Circulation JO - Circulation VL - 110 IS - 14 N2 - BACKGROUND: Limited data are available on the impact of prehospital thrombolysis (PHT) in the "real-world" setting. METHODS AND RESULTS: Of 443 intensive care units in France, 369 (83%) prospectively collected all cases of infarction (< or =48 hours of symptom onset) in November 2000; 1922 patients (median age, 67 years; 73% men) with ST-segment-elevation infarction were included, of whom 180 (9%) received intravenous thrombolysis before hospital admission (PHT). Patients with PHT were younger than those with in-hospital thrombolysis, primary percutaneous interventions, or no reperfusion therapy. Median time from symptom onset to hospital admission was 3.6 hours for PHT, 3.5 hours for in-hospital lysis, 3.2 hours for primary percutaneous interventions, and 12 hours for no reperfusion therapy. In-hospital death was 3.3% for PHT, 8.0% for in-hospital lysis, 6.7% for primary percutaneous interventions, and 12.2% for no reperfusion therapy. One-year survival was 94%, 89%, 89%, and 79%, respectively. In a multivariate analysis of predictors of 1-year survival, PHT was associated with a 0.49 relative risk of death (95% CI, 0.24 to 1.00; P=0.05). When the analysis was limited to patients receiving reperfusion therapy, the relative risk of death for PHT was 0.52 (95% CI, 0.25 to 1.08; P=0.08). In patients with PHT admitted in < or =3.5 hours, in-hospital mortality was 0% and 1-year survival was 99%. CONCLUSIONS: The 1-year outcome of patients treated with PHT compares favorably with that of patients treated with other modes of reperfusion therapy; this favorable trend persists after multivariate adjustment. Patients with PHT admitted very early have a very high 1-year survival rate. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/15451803/Impact_of_prehospital_thrombolysis_for_acute_myocardial_infarction_on_1_year_outcome:_results_from_the_French_Nationwide_USIC_2000_Registry_ L2 - https://www.ahajournals.org/doi/10.1161/01.CIR.0000143144.82338.36?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -