Display Settings:

Format

Send to:

Choose Destination
Eur Heart J. 2009 Jul;30(13):1598-606. doi: 10.1093/eurheartj/ehp156. Epub 2009 May 8.

Comparison of primary angioplasty and pre-hospital fibrinolysis in acute myocardial infarction (CAPTIM) trial: a 5-year follow-up.

Collaborators (154)

Touboul P, Leizorovicz A, Lacroute JM, Cassagnes J, Blanc JL, Touboul P, Leizorovicz A, Touboul P, Leizorovicz A, Teppe JP, Fernandez C, Bost V, Akkal A, Akkal Z, Thien C, Bugnard F, Mercier C, Chabaud S, Lorenzelli F, Visele N, Lacroute JM, Lacroute J, Beaune J, Cassagnes J, Cattan S, Danchin N, Dubois-Rande JL, Dupouy P, Grollier G, Isaaz K, Jullien T, Machecourt J, Puel J, Quiret JC, Slama M, Spaulding C, Blanc JL, Boudet F, Boullenger E, Carmes C, Cristofini P, Lacroute JM, Magne P, Margenet A, Nace L, Nemitz B, Pasteyer J, Prost G, Bassand JP, Charbonnier B, Goldstein P, Grolleau R, Lambert Y, Coppere B, Holzapfel L, Jacques D, Lopez M, Nighoghossian N, Ollivier L, De Breyne B, Lapandry C, Magne P, Prost G, Grand E, Petit P, Cristofini P, Boudet F, Saidi W, Boullenger E, Charpentier S, Lacroute JM, Lespiaucq Ch, Nemitz B, Boyer C, Margenet A, Bertrand C, Pasteyer J, Templier F, Carmes C, Blanc JL, Nace L, Beaune J, Durand De Gevigney G, Finet G, Fatemi M, Hadour G, Cattan S, Machecourt J, Richard S, Cassagnes J, Lusson JR, Motreff P, Lusson D, Jullien T, Drane F, Quiret JC, Leborgne L, Jarry G, Dubois-Rande JL, El Hamine S, Dupouy P, Teiger E, Veyssière F, Puel J, Jean M, Elbaz M, Galinier M, Cabrol P, Gryman R, Boccara A, Fourchard V, Kadiri A, Coumel P, Beaufils P, Tarragano F, Bourdarias JP, Joseph T, Spaulding C, Richard P, Belaouchi F, Grollier G, Gibert S, Aubry P, Farnoud R, Picauville K, Colloc E, Vahanian A, Garbaz E, Michaud P, Isaaz K, Cerisier A, Richard L, Metzger JP, Beygui F, Guerot C, Bougrini K, Durand E, Slama M, Carel Y, Colin P, Aliot E, Ethevenot G, Krafft R, Monsegu J, Danchin N, Houriez P, Makowski S, Pilliere R, Durand P, Cador R, Lesueur M, Drobinski G, Thomas D, Francoual M.

Author information

  • 1UMR 5558, Univeristé Lyon 1 et Centre d'Investigation Clinique, Hôpital Cardio-Vasculaire et Pneumologique, Hospices Civils de Lyon, 69394 Lyon Cedex 03, France. eric.bonnefoy-cudraz@chu-lyon.fr

Abstract

AIMS:

The CAPTIM (Comparison of primary Angioplasty and Pre-hospital fibrinolysis In acute Myocardial infarction) study found no evidence that a strategy of primary angioplasty was superior in terms of 30-day outcomes to a strategy of pre-hospital fibrinolysis with transfer to an interventional facility in patients managed early at the acute phase of an acute myocardial infarction. The present analysis was designed to compare both strategies at 5 years.

METHODS AND RESULTS:

The CAPTIM study included 840 patients managed in a pre-hospital setting within 6 h of an acute ST-segment elevation myocardial infarction. Patients were randomized to either a primary angioplasty (n = 421) or a pre-hospital fibrinolysis (rt-PA) with immediate transfer to a centre with interventional facilities (n = 419). Long-term follow-up was obtained in blinded fashion from 795 patients (94.6%). Using an intent-to-treat analysis, all-cause mortality at 5 years was 9.7% in the pre-hospital fibrinolysis group when compared with 12.6% in the primary angioplasty group [HR 0.75 (95% CI, 0.50-1.14); P = 0.18]. For patients included within 2 h, 5 year mortality was 5.8% in the pre-hospital fibrinolysis group when compared with 11.1% in the primary angioplasty group [HR 0.50 (95% CI, 0.25-0.97); P = 0.04], whereas it was, respectively, 14.5 and 14.4% in patients included after 2 h [HR 1.02, (95% CI 0.59-1.75), P = 0.92].

CONCLUSION:

The 5-year follow-up is consistent with the 30-day outcomes of the trial, showing similar mortality for primary percutaneous coronary intervention and a policy of pre-hospital lysis followed by transfer to an interventional center. In addition, for patients treated within 2 h of symptom onset, 5-year mortality was lower with pre-hospital lysis.

PMID:
19429632
[PubMed - indexed for MEDLINE]
Free full text
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for HighWire
    Loading ...
    Write to the Help Desk