title: Benefit of onsite reperfusion therapy or transfer to primary PCI in STEMI patients admitted to hospitals without catheterization laboratory. Results of the MITRA PLUS Registry.
abstract: The optimal reperfusion strategy in elderly patients with ST-segment elevation myocardial infarction (STEMI) remains a topic of debate. Therefore, we investigated in the MITRA PLUS registry clinical outcome variables in 5455 patients aged>70 years and STEMI on admission at hospitals without the facilities of coronary catheterization and PCI. Outcome was compared after thrombolysis, transfer to PCI and after no reperfusion therapy. Data of this registry in STEMI patients older than 70 years, who were transferred to another hospital for PCI, showed a strong trend for lower in-hospital mortality rates compared with a strategy with sole fibrinolysis and significantly lower in hospital death rates compared with a conservative treatment without (medical or mechanical) reperfusion. Additionally, the PCI group also had a reduced incidence of the combined events: death, myocardial reinfarction, stroke in comparison with both other infarct groups. Data of the presented MITRA PLUS registry in STEMI patients older than 70 years support data of several other studies, that patients with STEMI benefit from a transfer to primary PCI even after a time delay of symptom onset to hospital admission of more than 2 h compared with a strategy using sole fibrinolytic therapy.
authors.affiliation: Städtisches Klinikum, Klinik f. Kardiologie u. Allg. Innere Medizin, Solingen, Germany. kristinaszb@aol.com
authors.forename: Sebastian
authors.initials: S
authors.lastname: Szabo
authors.forename: Uwe
authors.initials: U
authors.lastname: Zeymer
authors.forename: Anselm
authors.initials: A
authors.lastname: Gitt
authors.forename: Harm
authors.initials: H
authors.lastname: Wienbergen
authors.forename: Roger
authors.initials: R
authors.lastname: Marx
authors.forename: Tobias
authors.initials: T
authors.lastname: Heer
authors.forename: Hans Martin
authors.initials: HM
authors.lastname: Hoffmeister
authors.forename: Jochen
authors.initials: J
authors.lastname: Senges
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000503:physiopathology / Q000628:therapy*; D015425:Myocardial Reperfusion; D010360:Patient Transfer; D012042:Registries; D012307:Risk Factors; D015912:Thrombolytic Therapy; D016896:Treatment Outcome