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Circulation 2001;104:2632-2634. Time from Symptom Onset to Study Treatment in Large Scale Thrombolytic Trials. 2.8. 2.7. 2.9. 2.8. 2.7. 2.7. Median Time (hrs) Between Symptom Onset and Treatment. ASSENT 3 00-01. GUSTO V 99-01. ASSENT II 97-98. GUSTO I 90-93. GUSTO III 95-97.

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slide3

Time from Symptom Onset to Study Treatment in Large Scale Thrombolytic Trials

2.8

2.7

2.9

2.8

2.7

2.7

Median Time (hrs) Between Symptom Onset and Treatment

ASSENT 3

00-01

GUSTO V

99-01

ASSENT II

97-98

GUSTO I

90-93

GUSTO III

95-97

InTIME II

97-99

Gibson CM, Circulation 2001;104:2632-2634

slide4

Benefits of PCI vs Lysis: The Importance of Timing

Kent DM et al Eff Clin Pract 4: 214, 2001

primary pci for stemi time to reperfusion and 30 day mortality
Primary PCI for STEMITime to Reperfusion and 30 Day Mortality

CADILLAC

Zwolle

N= 2002

N= 1791 1994-2001

9.6

P=0.04 (< 3h v > 3 h)

P < 0.001

% Mortality

5.6

2.3

2.2

3.1

2.5

0.9

Cox ACC ‘03 Abst 827-1

DeLuca ACC ‘03 Abst 827-3

Time to Reperfusion (h)

slide6

NRMI-2: Primary PCI Door-to-Balloon time vs. Mortality

N=27,080

P < 0.00001

Door-to-Balloon Time (minutes)

door to balloon times among patients transferred in nrmi 4
Door to Balloon Times Among Patients Transferred in NRMI 4

Data to

Cath Lab Arrival:

50th: 137 Min.

25th: 87 Min.

75th: 220 Min.

Cath Lab to

Balloon:

50th: 39 Min.

25th: 29 Min

75th: 53 Min.

Door to

Data:

50th: 8 Min.

25th: 4 Min.

75th: 16 Min.

8

137

39

Total Door to Balloon Time: 198 minutes (25th: 137; 75th: 281)

Percent of Patients with Door to Balloon Time < 90 Min.: 4.8%

Sample Size: 1,292; Time Period: October 2000 – September 2001

NRMI 4 Transfer-In Annual Data Report 2002

Gibson 2003

danami vs us ami are we as quick in the us
DANAMI vs US AMI: Are We As Quick In The US?

198 Min.

110 Min.

90 Min.

Median Time (Min.)

US AMI

Transfer 1o PCI

DANAMI

Transfer 1o PCI

DANAMI

On Site 1o PCI