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The impact of pre-hospital thrombolytic treatment on re-infarction rates: analysis of the Myocardial Infarction National Audit Project (MINAP)

S Horne, C Weston, T Quinn, A Hicks, L Walker, R Chen, J Birkhead, Clive Weston Orcid Logo

Heart, Volume: 95, Issue: 7, Pages: 559 - 563

Swansea University Author: Clive Weston Orcid Logo

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Abstract

The objective was to report on rate and predictors of re-infarction following thrombolytic treatment of ST-elevation myocardial infarction (STEMI) in an observational study of 35 356 patients treated by ambulance services and admitting hospitals in England and Wales and entered in the Myocardial Inf...

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Published in: Heart
ISSN: 1355-6037
Published: Heart 2009
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URI: https://cronfa.swan.ac.uk/Record/cronfa10010
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2017-03-09T22:15:25.0398679</datestamp><bib-version>v2</bib-version><id>10010</id><entry>2012-03-21</entry><title>The impact of pre-hospital thrombolytic treatment on re-infarction rates: analysis of the Myocardial Infarction National Audit Project (MINAP)</title><swanseaauthors><author><sid>df85e4e0e139d0f46eb683174eba98a9</sid><ORCID>0000-0002-8995-8199</ORCID><firstname>Clive</firstname><surname>Weston</surname><name>Clive Weston</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2012-03-21</date><deptcode>PMSC</deptcode><abstract>The objective was to report on rate and predictors of re-infarction following thrombolytic treatment of ST-elevation myocardial infarction (STEMI) in an observational study of 35&#x2009;356 patients treated by ambulance services and admitting hospitals in England and Wales and entered in the Myocardial Infarction National Audit Project (MINAP) in 2005&#x2013;6.For 22&#x2009;391 patients (63.3%) the presence or absence of re-infarction was recorded, and 1460 (6.5%) had re-infarction. Re-infarction rates were 6.5% for reteplase 6.4% for tenecteplase (6.4%); When the pre-hospital treatment to hospital arrival delay was greater than 30 minutes, re-infarction rates were 12.5% for reteplase, and 11.4% for tenecteplase. Re-infarction was more frequent after pre-hospital treatment with tenecteplase than reteplase (9.6% vs 6.6%, p&#x200A;=&#x200A;0.005). After multivariate analysis independent predictors of re-infarction for tenecteplase were pre-hospital treatment, OR 1.44 (95% CI 1.21 to 1.71, p&amp;#60;0.001) and weight in the highest quartile compared to the lowest, OR 1.66 (95% CI 1.19 to 2.31, p&#x200A;=&#x200A;0.003). For reteplase neither factor predicted re-infarction. Bleeding was less common with pre-hospital treatment&#x2014;overall 1.8% against 3.1%; intracerebral bleeding 0.4% against 0.7%.Pre-hospital treatment with tenecteplase was associated with higher re-infarction rates. Longer intervals from pre-hospital treatment to arrival in hospital were associated with high re-infarction rates for both tenecteplase and reteplase.</abstract><type>Journal Article</type><journal>Heart</journal><volume>95</volume><journalNumber>7</journalNumber><paginationStart>559</paginationStart><paginationEnd>563</paginationEnd><publisher>Heart</publisher><issnPrint>1355-6037</issnPrint><issnElectronic/><keywords/><publishedDay>31</publishedDay><publishedMonth>12</publishedMonth><publishedYear>2009</publishedYear><publishedDate>2009-12-31</publishedDate><doi>10.1136/hrt.2007.126821</doi><url/><notes/><college>COLLEGE NANME</college><department>Medicine</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>PMSC</DepartmentCode><institution>Swansea University</institution><apcterm/><lastEdited>2017-03-09T22:15:25.0398679</lastEdited><Created>2012-03-21T16:17:18.0000000</Created><path><level id="1">Swansea University Medical School</level><level id="2">Medicine</level></path><authors><author><firstname>S</firstname><surname>Horne</surname><order>1</order></author><author><firstname>C</firstname><surname>Weston</surname><order>2</order></author><author><firstname>T</firstname><surname>Quinn</surname><order>3</order></author><author><firstname>A</firstname><surname>Hicks</surname><order>4</order></author><author><firstname>L</firstname><surname>Walker</surname><order>5</order></author><author><firstname>R</firstname><surname>Chen</surname><order>6</order></author><author><firstname>J</firstname><surname>Birkhead</surname><order>7</order></author><author><firstname>Clive</firstname><surname>Weston</surname><orcid>0000-0002-8995-8199</orcid><order>8</order></author></authors><documents/><OutputDurs/></rfc1807>
spelling 2017-03-09T22:15:25.0398679 v2 10010 2012-03-21 The impact of pre-hospital thrombolytic treatment on re-infarction rates: analysis of the Myocardial Infarction National Audit Project (MINAP) df85e4e0e139d0f46eb683174eba98a9 0000-0002-8995-8199 Clive Weston Clive Weston true false 2012-03-21 PMSC The objective was to report on rate and predictors of re-infarction following thrombolytic treatment of ST-elevation myocardial infarction (STEMI) in an observational study of 35 356 patients treated by ambulance services and admitting hospitals in England and Wales and entered in the Myocardial Infarction National Audit Project (MINAP) in 2005–6.For 22 391 patients (63.3%) the presence or absence of re-infarction was recorded, and 1460 (6.5%) had re-infarction. Re-infarction rates were 6.5% for reteplase 6.4% for tenecteplase (6.4%); When the pre-hospital treatment to hospital arrival delay was greater than 30 minutes, re-infarction rates were 12.5% for reteplase, and 11.4% for tenecteplase. Re-infarction was more frequent after pre-hospital treatment with tenecteplase than reteplase (9.6% vs 6.6%, p = 0.005). After multivariate analysis independent predictors of re-infarction for tenecteplase were pre-hospital treatment, OR 1.44 (95% CI 1.21 to 1.71, p&#60;0.001) and weight in the highest quartile compared to the lowest, OR 1.66 (95% CI 1.19 to 2.31, p = 0.003). For reteplase neither factor predicted re-infarction. Bleeding was less common with pre-hospital treatment—overall 1.8% against 3.1%; intracerebral bleeding 0.4% against 0.7%.Pre-hospital treatment with tenecteplase was associated with higher re-infarction rates. Longer intervals from pre-hospital treatment to arrival in hospital were associated with high re-infarction rates for both tenecteplase and reteplase. Journal Article Heart 95 7 559 563 Heart 1355-6037 31 12 2009 2009-12-31 10.1136/hrt.2007.126821 COLLEGE NANME Medicine COLLEGE CODE PMSC Swansea University 2017-03-09T22:15:25.0398679 2012-03-21T16:17:18.0000000 Swansea University Medical School Medicine S Horne 1 C Weston 2 T Quinn 3 A Hicks 4 L Walker 5 R Chen 6 J Birkhead 7 Clive Weston 0000-0002-8995-8199 8
title The impact of pre-hospital thrombolytic treatment on re-infarction rates: analysis of the Myocardial Infarction National Audit Project (MINAP)
spellingShingle The impact of pre-hospital thrombolytic treatment on re-infarction rates: analysis of the Myocardial Infarction National Audit Project (MINAP)
Clive Weston
title_short The impact of pre-hospital thrombolytic treatment on re-infarction rates: analysis of the Myocardial Infarction National Audit Project (MINAP)
title_full The impact of pre-hospital thrombolytic treatment on re-infarction rates: analysis of the Myocardial Infarction National Audit Project (MINAP)
title_fullStr The impact of pre-hospital thrombolytic treatment on re-infarction rates: analysis of the Myocardial Infarction National Audit Project (MINAP)
title_full_unstemmed The impact of pre-hospital thrombolytic treatment on re-infarction rates: analysis of the Myocardial Infarction National Audit Project (MINAP)
title_sort The impact of pre-hospital thrombolytic treatment on re-infarction rates: analysis of the Myocardial Infarction National Audit Project (MINAP)
author_id_str_mv df85e4e0e139d0f46eb683174eba98a9
author_id_fullname_str_mv df85e4e0e139d0f46eb683174eba98a9_***_Clive Weston
author Clive Weston
author2 S Horne
C Weston
T Quinn
A Hicks
L Walker
R Chen
J Birkhead
Clive Weston
format Journal article
container_title Heart
container_volume 95
container_issue 7
container_start_page 559
publishDate 2009
institution Swansea University
issn 1355-6037
doi_str_mv 10.1136/hrt.2007.126821
publisher Heart
college_str Swansea University Medical School
hierarchytype
hierarchy_top_id swanseauniversitymedicalschool
hierarchy_top_title Swansea University Medical School
hierarchy_parent_id swanseauniversitymedicalschool
hierarchy_parent_title Swansea University Medical School
department_str Medicine{{{_:::_}}}Swansea University Medical School{{{_:::_}}}Medicine
document_store_str 0
active_str 0
description The objective was to report on rate and predictors of re-infarction following thrombolytic treatment of ST-elevation myocardial infarction (STEMI) in an observational study of 35 356 patients treated by ambulance services and admitting hospitals in England and Wales and entered in the Myocardial Infarction National Audit Project (MINAP) in 2005–6.For 22 391 patients (63.3%) the presence or absence of re-infarction was recorded, and 1460 (6.5%) had re-infarction. Re-infarction rates were 6.5% for reteplase 6.4% for tenecteplase (6.4%); When the pre-hospital treatment to hospital arrival delay was greater than 30 minutes, re-infarction rates were 12.5% for reteplase, and 11.4% for tenecteplase. Re-infarction was more frequent after pre-hospital treatment with tenecteplase than reteplase (9.6% vs 6.6%, p = 0.005). After multivariate analysis independent predictors of re-infarction for tenecteplase were pre-hospital treatment, OR 1.44 (95% CI 1.21 to 1.71, p&#60;0.001) and weight in the highest quartile compared to the lowest, OR 1.66 (95% CI 1.19 to 2.31, p = 0.003). For reteplase neither factor predicted re-infarction. Bleeding was less common with pre-hospital treatment—overall 1.8% against 3.1%; intracerebral bleeding 0.4% against 0.7%.Pre-hospital treatment with tenecteplase was associated with higher re-infarction rates. Longer intervals from pre-hospital treatment to arrival in hospital were associated with high re-infarction rates for both tenecteplase and reteplase.
published_date 2009-12-31T03:24:09Z
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