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Coronary artery disease
A prospective, observational, multicentre study comparing tenecteplase facilitated PCI versus primary PCI in Indian patients with STEMI (STEPP—AMI) Suma M Victor,1 Vijayakumar Subban,1 Thomas Alexander,2 Bahuleyan C G,3 Arun Srinivas,4 Selvamani S,5 Ajit S Mullasari6
To cite: Victor SM, Subban V, Alexander T, et al. A prospective, observational, multicentre study comparing tenecteplase facilitated PCI versus primary PCI in Indian patients with STEMI (STEPP —AMI). Open Heart 2014;1: e000133. doi:10.1136/ openhrt-2014-000133
▸ Additional material is available. To view please visit the journal (http://dx.doi.org/ 10.1136/openhrt-2014000133). The study was conducted by ‘Madras Medical Mission’, Chennai, India. Received 13 April 2014 Revised 3 July 2014 Accepted 26 July 2014
For numbered affiliations see end of article. Correspondence to Dr Suma M Victor; [email protected]
ABSTRACT Objective: To compare the efficacy of pharmacoinvasive strategy versus primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI). Primary PCI is the preferred treatment for STEMI, but it is not a feasible option for many. A pharmacoinvasive strategy might be a practical solution in the Indian context, although few empirical data exist to guide this approach. Methods: This is a prospective, observational, multicentre pilot study. Two hundred consecutive patients with STEMI aged 18–75 years, presenting within 12 h of onset of symptoms and requiring a reperfusion strategy, were studied from five primary PCI capable centres in South India. Patients who opted for pharmacoinvasive strategy (n=45) formed group A. Group B consisted of patients treated with primary PCI (n=155). One patient was lost to follow-up at 1 year. The primary end point was a composite of death, cardiogenic shock, reinfarction, repeat revascularisation of a culprit artery and congestive heart failure at 30 days. Results: The primary end point occurred in 11.1% in group A and in 3.9% in group B, p=0.07 (RR=2.87; 95% CI 0.92 to 8.97). The infarct-related artery patency at angiogram was 82.2% in group A and 22.6% in group B (p
Coronary artery disease
A prospective, observational, multicentre study comparing tenecteplase facilitated PCI versus primary PCI in Indian patients with STEMI (STEPP—AMI) Suma M Victor,1 Vijayakumar Subban,1 Thomas Alexander,2 Bahuleyan C G,3 Arun Srinivas,4 Selvamani S,5 Ajit S Mullasari6
To cite: Victor SM, Subban V, Alexander T, et al. A prospective, observational, multicentre study comparing tenecteplase facilitated PCI versus primary PCI in Indian patients with STEMI (STEPP —AMI). Open Heart 2014;1: e000133. doi:10.1136/ openhrt-2014-000133
▸ Additional material is available. To view please visit the journal (http://dx.doi.org/ 10.1136/openhrt-2014000133). The study was conducted by ‘Madras Medical Mission’, Chennai, India. Received 13 April 2014 Revised 3 July 2014 Accepted 26 July 2014
For numbered affiliations see end of article. Correspondence to Dr Suma M Victor; [email protected]
ABSTRACT Objective: To compare the efficacy of pharmacoinvasive strategy versus primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI). Primary PCI is the preferred treatment for STEMI, but it is not a feasible option for many. A pharmacoinvasive strategy might be a practical solution in the Indian context, although few empirical data exist to guide this approach. Methods: This is a prospective, observational, multicentre pilot study. Two hundred consecutive patients with STEMI aged 18–75 years, presenting within 12 h of onset of symptoms and requiring a reperfusion strategy, were studied from five primary PCI capable centres in South India. Patients who opted for pharmacoinvasive strategy (n=45) formed group A. Group B consisted of patients treated with primary PCI (n=155). One patient was lost to follow-up at 1 year. The primary end point was a composite of death, cardiogenic shock, reinfarction, repeat revascularisation of a culprit artery and congestive heart failure at 30 days. Results: The primary end point occurred in 11.1% in group A and in 3.9% in group B, p=0.07 (RR=2.87; 95% CI 0.92 to 8.97). The infarct-related artery patency at angiogram was 82.2% in group A and 22.6% in group B (p
