Skip to main content
NCBI home page
Heart logoLink to Heart
. 1997 Oct;78(4):333–336. doi: 10.1136/hrt.78.4.333

Transferring patients for primary angioplasty: a retrospective analysis of 104 selected high risk patients with acute myocardial infarction

F Zijlstra 1, H van`t 1, A L Liem 1, J Hoorntje 1, H Suryapranata 1, M-J de Boer 1
PMCID: PMC1892264  PMID: 9404245

Abstract

Objective—To investigate the feasibility of primary coronary angioplasty as a treatment option in patients with acute myocardial infarction after initial diagnosis in a local community hospital.
Setting—Referral centre for interventional treatment of coronary artery disease.
Methods—During a five year period, 520 candidates for primary coronary angioplasty were treated in our institution, 104 after transfer from a community hospital. The transferred patients and the non-transferred patients (n = 416) were compared with regard to baseline clinical characteristics, time interval from symptom onset to treatment, and clinical outcome at six months.
Results—In this setting, the influence of transportation on total ischaemic time was limited, and there was no difference in clinical outcome between the transferred and the non-transferred patients. Clinical outcome was mainly dependent on the indication for transfer.
Conclusions—Safe and expedient transportation may facilitate the more widespread use of primary angioplasty in patients with acute myocardial infarction. A large randomised multicentre trial is needed to compare the relative merits of intravenous thrombolytic treatment in a local hospital with primary angioplasty after transfer in selected high risk patients with acute myocardial infarction.

 Keywords: myocardial infarction;  coronary angioplasty;  reperfusion

Full Text

The Full Text of this article is available as a PDF (96.7 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bellinger R. L., Califf R. M., Mark D. B., Weber R. A., Collins P., Stone J., Phillips H. R., 3rd, German L., Stack R. S. Helicopter transport of patients during acute myocardial infarction. Am J Cardiol. 1988 Apr 1;61(10):718–722. doi: 10.1016/0002-9149(88)91054-5. [DOI] [PubMed] [Google Scholar]
  2. Boyle R. M. Immediate angioplasty in the United Kingdom. Br Heart J. 1995 May;73(5):413–414. doi: 10.1136/hrt.73.5.413. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Brodie B. R. Primary angioplasty in a community hospital in the USA. Br Heart J. 1995 May;73(5):411–412. doi: 10.1136/hrt.73.5.411. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Brodie B. R., Weintraub R. A., Stuckey T. D., LeBauer E. J., Katz J. D., Kelly T. A., Hansen C. J. Outcomes of direct coronary angioplasty for acute myocardial infarction in candidates and non-candidates for thrombolytic therapy. Am J Cardiol. 1991 Jan 1;67(1):7–12. doi: 10.1016/0002-9149(91)90090-8. [DOI] [PubMed] [Google Scholar]
  5. Gore J. M., Corrao J. M., Goldberg R. J., Ball S. P., Weiner B. H., Aghababian R. V., Dalen J. E. Feasibility and safety of emergency interhospital transport of patients during early hours of acute myocardial infarction. Arch Intern Med. 1989 Feb;149(2):353–355. [PubMed] [Google Scholar]
  6. Gore J. M., Granger C. B., Simoons M. L., Sloan M. A., Weaver W. D., White H. D., Barbash G. I., Van de Werf F., Aylward P. E., Topol E. J. Stroke after thrombolysis. Mortality and functional outcomes in the GUSTO-I trial. Global Use of Strategies to Open Occluded Coronary Arteries. Circulation. 1995 Nov 15;92(10):2811–2818. doi: 10.1161/01.cir.92.10.2811. [DOI] [PubMed] [Google Scholar]
  7. Grines C. L., Browne K. F., Marco J., Rothbaum D., Stone G. W., O'Keefe J., Overlie P., Donohue B., Chelliah N., Timmis G. C. A comparison of immediate angioplasty with thrombolytic therapy for acute myocardial infarction. The Primary Angioplasty in Myocardial Infarction Study Group. N Engl J Med. 1993 Mar 11;328(10):673–679. doi: 10.1056/NEJM199303113281001. [DOI] [PubMed] [Google Scholar]
  8. Grines C. L., O'Neill W. W. Primary angioplasty. Br Heart J. 1995 May;73(5):405–406. doi: 10.1136/hrt.73.5.405. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Hillis L. D., Forman S., Braunwald E. Risk stratification before thrombolytic therapy in patients with acute myocardial infarction. The Thrombolysis in Myocardial Infarction (TIMI) Phase II Co-Investigators. J Am Coll Cardiol. 1990 Aug;16(2):313–315. doi: 10.1016/0735-1097(90)90579-e. [DOI] [PubMed] [Google Scholar]
  10. Kligfield P. Primary angioplasty in myocardial infarction. Br Heart J. 1995 May;73(5):403–403. doi: 10.1136/hrt.73.5.403. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Lenfant C. NHLBI funding policies. Enhancing stability, predictability, and cost control. Circulation. 1994 Jul;90(1):1–1. doi: 10.1161/01.cir.90.1.1. [DOI] [PubMed] [Google Scholar]
  12. Ramsdale D. R., Grech E. D. Experience of primary angioplasty in the United Kingdom. Br Heart J. 1995 May;73(5):414–416. doi: 10.1136/hrt.73.5.414. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Simoons M. L., Arnold A. E. Tailored thrombolytic therapy. A perspective. Circulation. 1993 Dec;88(6):2556–2564. doi: 10.1161/01.cir.88.6.2556. [DOI] [PubMed] [Google Scholar]
  14. Vaitkus P. T. Limitations of primary angioplasty in acute myocardial infarction. Br Heart J. 1995 May;73(5):409–410. doi: 10.1136/hrt.73.5.409. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Zijlstra F. Primary angioplasty is the most effective treatment for an acute myocardial infarction. Br Heart J. 1995 May;73(5):403–404. doi: 10.1136/hrt.73.5.403-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Zijlstra F., de Boer M. J., Hoorntje J. C., Reiffers S., Reiber J. H., Suryapranata H. A comparison of immediate coronary angioplasty with intravenous streptokinase in acute myocardial infarction. N Engl J Med. 1993 Mar 11;328(10):680–684. doi: 10.1056/NEJM199303113281002. [DOI] [PubMed] [Google Scholar]
  17. de Boer M. J., Reiber J. H., Suryapranata H., van den Brand M. J., Hoorntje J. C., Zijlstra F. Angiographic findings and catheterization laboratory events in patients with primary coronary angioplasty or streptokinase therapy for acute myocardial infarction. Eur Heart J. 1995 Oct;16(10):1347–1355. doi: 10.1093/oxfordjournals.eurheartj.a060741. [DOI] [PubMed] [Google Scholar]
  18. de Boer M. J., Suryapranata H., Hoorntje J. C., Reiffers S., Liem A. L., Miedema K., Hermens W. T., van den Brand M. J., Zijlstra F. Limitation of infarct size and preservation of left ventricular function after primary coronary angioplasty compared with intravenous streptokinase in acute myocardial infarction. Circulation. 1994 Aug;90(2):753–761. doi: 10.1161/01.cir.90.2.753. [DOI] [PubMed] [Google Scholar]
  19. de Jaegere P. P., Simoons M. L. Immediate angioplasty: a conservative view from Europe. Br Heart J. 1995 May;73(5):407–408. doi: 10.1136/hrt.73.5.407. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Heart are provided here courtesy of BMJ Publishing Group

RESOURCES