Long distance transport for primary angioplasty vs immediate thrombolysis in acute myocardial infarction: Final results of the randomized national multicentre trial-PRAGUE-2
Abstrakt
The aim of this multicentre national randomized mortality trial was to test whether the nationwide change in treatment guidelines (transportation of all patients to PCI centres) was warranted. Methods: The PRAGUE-2 study randomized 850 patients with acute ST elevation myocardial infarction presenting within 3 h after the onset of symptoms, the mortality of the TL group reached 15.3% compared to 6% in the PCI group (P<0.02).
Patients randomized within <3 h of symptom onset (n=551) had no difference in mortality whether treated by TL (7.4%) or transferred to PCI (7.3%). A combined end-point occurred in 15.2% of the TL group vs 8.4% of the PCI group (P<0.003).
Conclusions: Long distance transport from a community hospital to a tertiary PCI centre in the acute phase of AMI is safe.