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Rigshospitalet - a part of Copenhagen University Hospital
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System delay and timing of intervention in acute myocardial infarction (from the Danish Acute Myocardial Infarction-2 [DANAMI-2] trial)

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  • Peter Nielsen
  • Christian Juhl Terkelsen
  • Torsten Nielsen
  • Leif Thuesen
  • Lars Romer Krusell
  • Per Thayssen
  • Henning Kelbaek
  • Ulrik Abildgaard
  • Anton Villadsen
  • Henning Andersen
  • Michael Maeng
  • Danami-2 Investigators
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The interval from the first alert of the healthcare system to the initiation of reperfusion therapy (system delay) is associated with mortality in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention (pPCI). The importance of system delay in patients treated with fibrinolysis versus pPCI has not been assessed. We obtained data on system delay from the Danish Acute Myocardial Infarction-2 study, which randomized 1,572 patients to fibrinolysis or pPCI. The study end points were 30-day and 8-year mortality. The short system delays were associated with reduced absolute mortality in both the fibrinolysis group (3 hours, 11.5%; test for trend, p = 0.08) and pPCI group (3 hours, 7.7%; test for trend, p = 0.02). The lowest 30-day mortality was obtained with pPCI and a system delay of 1 to 2 hours (vs fibrinolysis within 3 hours was associated with a similar 30-day and 8-year mortality as fibrinolysis within 1 to 2 hours. In conclusion, short system delays are associated with reduced mortality in patients with ST-segment elevation myocardial infarction treated with fibrinolysis as well as pPCI. pPCI performed with a system delay of
Original languageEnglish
JournalAmerican Journal of Cardiology
Volume108
Issue number6
Pages (from-to)776-81
Number of pages6
ISSN0002-9149
DOIs
Publication statusPublished - 2011

    Research areas

  • Aged, Angioplasty, Balloon, Coronary, Chi-Square Distribution, Denmark, Female, Fibrinolytic Agents, Humans, Male, Middle Aged, Myocardial Infarction, Myocardial Reperfusion, Prognosis, Proportional Hazards Models, Risk Factors, Thrombolytic Therapy, Time Factors, Treatment Outcome

ID: 33265497