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Danish multicenter randomized study on fibrinolytic therapy versus acute coronary angioplasty in acute myocardial infarction: rationale and design of the DANish trial in Acute Myocardial Infarction-2 (DANAMI-2).

Abstract：

BACKGROUND:Randomized trials have indicated that primary coronary angioplasty performed in patients admitted directly to highly-experienced angioplasty centers offers certain advantages over intravenous fibrinolytic therapy. However, the large majority of patients with acute myocardial infarction are submitted to hospitals without a catheterization laboratory. This means that additional transportation will be necessary for many patients if a strategy of acute coronary angioplasty is to be introduced as routine treatment. The delay of treatment caused by transportation might negate (part of) the benefits of primary angioplasty compared to fibrinolytic therapy given immediately at the local hospital. STUDY DESIGN:The DANish trial in Acute Myocardial Infarction-2 (DANAMI-2) is the first large-scale study to clarify, in a whole community, which of the 2 treatment strategies is best. A total of 1900 patients with ST-elevation myocardial infarction are to be randomized: 800 patients will be admitted to invasive hospitals and 1100 patients will be admitted to referral hospitals. Half of the 1100 patients admitted to referral hospitals will immediately be transferred to an invasive center to be treated with primary angioplasty. IMPLICATIONS:If acute transfer from a local hospital to an angioplasty center is the superior strategy, primary angioplasty should be offered to all patients as routine treatment on a community basis.

journal_name

Am Heart J

journal_title

American heart journal

authors

Andersen HR,Nielsen TT,Vesterlund T,Grande P,Abildgaard U,Thayssen P,Pedersen F,Mortensen LS,DANAMI-2 Investigators.

doi

10.1016/S0002-8703(03)00316-8

subject

Has Abstract

pub_date

2003-08-01 00:00:00

pages

234-41

issue

2

eissn

0002-8703

issn

1097-6744

pii

S0002870303003168

journal_volume

146

pub_type

临床试验,杂志文章,多中心研究,随机对照试验

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