Influence of early prehospital thrombolysis on mortality and event-free survival (the Myocardial Infarction Triage and Intervention [MITI] Randomized Trial). MITI Project Investigators

The American Journal of Cardiology
M A BrouwerW D Weaver

Abstract

The Myocardial Infarction Triage and Intervention Trial of prehospital versus hospital administration of thrombolytic therapy markedly reduced hospital treatment times, but the 2 groups had similar outcomes. However, patients treated < 70 minutes from symptom onset had better short-term outcomes. The purpose of this study was to determine the long-term influence of very early thrombolytic treatment for acute myocardial infarction. A total of 360 patients were followed for vital status and cardiac-related hospital admissions over a period of 34 +/- 16 months. Patients enrolled in the trial had symptoms for < or = 6 hours, ST-segment elevation on the prehospital electrocardiogram, and no risk factors for serious bleeding. They received aspirin and recombinant tissue plasminogen activator either before or after hospital arrival. Primary end points in this study included long-term survival and survival free of death or readmission to the hospital for angina, myocardial infarction, congestive heart failure, or revascularization. Two-year survival was 89% for prehospital- and 91% for hospital-treated patients (p = 0.46). Event-free survival at 2 years was 56% and 64% for prehospital- and hospital-treated patients, respectively (p = 0...Continue Reading

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