[DANAMI. A Danish study of invasive versus conservative treatment of patients with post-infarction ischemia who had received thrombolytic therapy].
BACKGROUND
To compare an invasive strategy employing percutaneous transluminal coronary angioplasty (PTCA) or coronary artery by-pass grafting (CABG) with a medical strategy in patients who had received thrombolytic treatment for first acute myocardial infarction (AMI), and with signs of inducible ischaemia.


METHODS
In a prospective study 1008 patients were randomized, 503 to invasive treatment, of whom 266 (52.9%) had PTCA, and 147 (29.2%) CABG, 505 to conservative treatment, of whom eight (1.6%) were revascularized within two months.


RESULTS
After a median follow-up of 2.4 years the mortality in the invasive group was 3.6% vs. 4.4% (p = 0.45) in the conservative group, re-infarction incidence was 5.6% vs. 10.5% (p = 0.0038) and percentage of admissions with unstable angina was 17.9% vs. 29.5% (p < 0.00001).


CONCLUSIONS
We conclude that post-infarct patients with inducible ischaemia should be referred to coronary angiography and revascularised accordingly.
Madsen
J K
JK
jkmadsen@rh.dk
Grande
P
P
Saunamäki
K
K
Thayssen
P
P
Kasis
E
E
Eriksen
U H
UH
Rasmussen
K
K
Haunsø
S
S
Nielsen
T T
TT
Haghfelt
T H
TH
Hansen
P F
PF
Hjelms
E
E
Paulsen
P K
PK
Alstrup
P
P
Arendrup
H C
HC
Niebuhr-Jørgensen
U
U
Andersen
L I
LI
D000328:Adult; D000368:Aged; D000789:Angina, Unstable / Q000175:diagnosis; D015906:Angioplasty, Balloon, Coronary; D001026:Coronary Artery Bypass; D003718:Denmark / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000188:drug therapy / Q000401:mortality; D017202:Myocardial Ischemia / Q000188:drug therapy / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D009204:Myocardial Revascularization; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D015912:Thrombolytic Therapy; D016896:Treatment Outcome