Our mission is to become a worldwide reference for education in the field for all professionals involved in the process to disseminate knowledge & skills of Acute Cardiovascular Care.
Our mission is to promote excellence in clinical diagnosis, research, technical development, and education in cardiovascular imaging in Europe.
Our mission is to promote excellence in research, practice, education and policy in cardiovascular health, primary and secondary prevention.
Our mission is to reduce the burden of cardiovascular disease through percutaneous cardiovascular interventions.
Improving the quality of life and reducing sudden cardiac death by limiting the impact of heart rhythm disturbances.
Our mission is to improve quality of life and longevity, through better prevention, diagnosis and treatment of heart failure, including the establishment of networks for its management, education and research.
The ESC Working Groups' goal is to stimulate and disseminate scientific knowledge in different fields of cardiology.
The ESC Councils' goal is to share knowledge among medical professionals practising in specific cardiology domains.
OUR MISSION: TO REDUCE THE BURDEN OF CARDIOVASCULAR DISEASE
Prof. Freek Verheugt,
Ms Sigrun Halvorsen,
Presenter | see Discussant report
Sigrun Halvorsen, FESC (Norway)
List of Authors: Ellen Bøhmer, Pavel Hoffmann, Michael Abdelnoor, Harald Arnesen, Sigrun Halvorsen Abstract: Purpose: Thrombolysis remains the treatment of choice in ST-segment elevation myocardial infarction (STEMI) when primary PCI cannot be performed within 90-120 min. The efficacy and safety of early PCI after thrombolysis is still unclear. The aim of this study was to compare a strategy of immediate transfer for PCI after thrombolysis to an ischemia-guided approach, in patients with very long transfer distances. Methods: 266 patients with acute STEMI of < 6 h duration, living in rural areas in Norway with 100 - 400 km transfer distances to PCI were treated with full-dose tenecteplase, aspirin, enoxaparin and clopidogrel. Patients were randomized to immediate transfer for PCI, or to conservative management in the community hospitals with urgent transfer only if rescue indication or clinical deterioration. The primary outcome was a composite of death, reinfarction, stroke or new ischemia within 12 months, and analysis was by intention to treat. Results: The primary endpoint at 12 months was reached in 28 patients (21 %) in the early invasive group compared with 36 (27 %) in the conservative group (hazard ratio 0.72, 95% CI 0.44-1.18, p=0.19). The composite of death, reinfarction or stroke at 12 months was significantly reduced in the early invasive compared to the conservative group (6.0% versus 16%, hazard ratio 0.36, 95% CI 0.16-0.81, p=0.01). No significant differences in bleeding or infarct size were observed, and transport complications were few. Conclusions: Immediate transfer for PCI after thrombolysis did not improve the primary outcome significantly, but reduced the rate of death, reinfarction or stroke within 12 months compared to conservative treatment.
Discussant | see Presenter abstract
Freek Verheugt, FESC (Netherlands)
Immediate angioplasty versus ischemia-guided management after thrombolysis for ST-segment elevation myocardial infarction in areas with very long transfers: The NORDISTEMI study
This congress report accompanies a presentation given at the ESC Congress 2009. Written by the author himself/herself, this report does not necessarily reflect the opinion of the European Society of Cardiology.
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