ST-segment-elevation myocardial infarction patients randomized to a pharmaco-invasive strategy or primary percutaneous coronary intervention : Strategic Reperfusion Early After Myocardial Infarction (STREAM) 1-year mortality follow-up
© 2014 American Heart Association, Inc..
BACKGROUND: In the Strategic Reperfusion Early After Myocardial Infarction (STREAM) trial, a pharmaco-invasive (PI) strategy was compared with primary percutaneous coronary intervention (pPCI) in ST-segment-elevation myocardial infarction patients presenting within 3 hours after symptom onset but unable to undergo pPCI within 1 hour. At 30 days, the PI approach was associated with a nominally but nonstatistically significant lower incidence of the composite primary end point of death, shock, congestive heart failure, and reinfarction when compared with pPCI. The aim of the present study was to determine the effect of these strategies on 1-year mortality.
METHODS AND RESULTS: Vital status at 1 year was available in 936 of 944 (99.2%) and 941 of 948 (99.3%) patients in the PI and pPCI arm, respectively. At 1 year, all-cause mortality rates (6.7% versus 5.9%) were similar for PI and pPCI-treated patients (P=0.49; risk ratio, 1.13; 95% confidence interval, 0.79-1.62). Cardiac mortality rates were similar as well (4.0% versus 4.1%, P=0.93; risk ratio, 0.98; 95% confidence interval, 0.62-1.54). Overall, only 34 patients died between day 30 and 1 year, 20 in the PI arm and 14 in the pPCI arm, of whom 20 died of noncardiac reasons (13 in the PI and 7 in the pPCI arm). There was no significant difference in 1-year all-cause mortality between the 2 groups among the prespecified key subgroups.
CONCLUSIONS: At 1 year, mortality rates in the PI and pPCI arms were similar in ST-segment-elevation myocardial infarction patients presenting within 3 hours after symptom onset and unable to undergo pPCI within 1 hour.
CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT00623623.
| Errataetall: |
CommentIn: Circulation. 2014 Sep 30;130(14):1133-5. - PMID 25161046 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2014 |
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| Erschienen: |
2014 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:130 |
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| Enthalten in: |
Circulation - 130(2014), 14 vom: 30. Sept., Seite 1139-45 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Sinnaeve, Peter R [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 06.02.2015 Date Revised 02.12.2018 published: Print-Electronic ClinicalTrials.gov: NCT00623623 CommentIn: Circulation. 2014 Sep 30;130(14):1133-5. - PMID 25161046 Citation Status MEDLINE |
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| doi: |
10.1161/CIRCULATIONAHA.114.009570 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM241335396 |
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| 100 | 1 | |a Sinnaeve, Peter R |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a ST-segment-elevation myocardial infarction patients randomized to a pharmaco-invasive strategy or primary percutaneous coronary intervention |b Strategic Reperfusion Early After Myocardial Infarction (STREAM) 1-year mortality follow-up |
| 264 | 1 | |c 2014 | |
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| 500 | |a Date Completed 06.02.2015 | ||
| 500 | |a Date Revised 02.12.2018 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a ClinicalTrials.gov: NCT00623623 | ||
| 500 | |a CommentIn: Circulation. 2014 Sep 30;130(14):1133-5. - PMID 25161046 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2014 American Heart Association, Inc. | ||
| 520 | |a BACKGROUND: In the Strategic Reperfusion Early After Myocardial Infarction (STREAM) trial, a pharmaco-invasive (PI) strategy was compared with primary percutaneous coronary intervention (pPCI) in ST-segment-elevation myocardial infarction patients presenting within 3 hours after symptom onset but unable to undergo pPCI within 1 hour. At 30 days, the PI approach was associated with a nominally but nonstatistically significant lower incidence of the composite primary end point of death, shock, congestive heart failure, and reinfarction when compared with pPCI. The aim of the present study was to determine the effect of these strategies on 1-year mortality | ||
| 520 | |a METHODS AND RESULTS: Vital status at 1 year was available in 936 of 944 (99.2%) and 941 of 948 (99.3%) patients in the PI and pPCI arm, respectively. At 1 year, all-cause mortality rates (6.7% versus 5.9%) were similar for PI and pPCI-treated patients (P=0.49; risk ratio, 1.13; 95% confidence interval, 0.79-1.62). Cardiac mortality rates were similar as well (4.0% versus 4.1%, P=0.93; risk ratio, 0.98; 95% confidence interval, 0.62-1.54). Overall, only 34 patients died between day 30 and 1 year, 20 in the PI arm and 14 in the pPCI arm, of whom 20 died of noncardiac reasons (13 in the PI and 7 in the pPCI arm). There was no significant difference in 1-year all-cause mortality between the 2 groups among the prespecified key subgroups | ||
| 520 | |a CONCLUSIONS: At 1 year, mortality rates in the PI and pPCI arms were similar in ST-segment-elevation myocardial infarction patients presenting within 3 hours after symptom onset and unable to undergo pPCI within 1 hour | ||
| 520 | |a CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT00623623 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a anticoagulants | |
| 650 | 4 | |a catheterization | |
| 650 | 4 | |a myocardial infarction | |
| 650 | 4 | |a thrombolysis, therapeutic | |
| 650 | 7 | |a Anticoagulants |2 NLM | |
| 650 | 7 | |a Fibrinolytic Agents |2 NLM | |
| 650 | 7 | |a Tissue Plasminogen Activator |2 NLM | |
| 650 | 7 | |a EC 3.4.21.68 |2 NLM | |
| 650 | 7 | |a Tenecteplase |2 NLM | |
| 650 | 7 | |a WGD229O42W |2 NLM | |
| 700 | 1 | |a Armstrong, Paul W |e verfasserin |4 aut | |
| 700 | 1 | |a Gershlick, Anthony H |e verfasserin |4 aut | |
| 700 | 1 | |a Goldstein, Patrick |e verfasserin |4 aut | |
| 700 | 1 | |a Wilcox, Robert |e verfasserin |4 aut | |
| 700 | 1 | |a Lambert, Yves |e verfasserin |4 aut | |
| 700 | 1 | |a Danays, Thierry |e verfasserin |4 aut | |
| 700 | 1 | |a Soulat, Louis |e verfasserin |4 aut | |
| 700 | 1 | |a Halvorsen, Sigrun |e verfasserin |4 aut | |
| 700 | 1 | |a Ortiz, Fernando Rosell |e verfasserin |4 aut | |
| 700 | 1 | |a Vandenberghe, Katleen |e verfasserin |4 aut | |
| 700 | 1 | |a Regelin, Anne |e verfasserin |4 aut | |
| 700 | 1 | |a Bluhmki, Erich |e verfasserin |4 aut | |
| 700 | 1 | |a Bogaerts, Kris |e verfasserin |4 aut | |
| 700 | 1 | |a Van de Werf, Frans |e verfasserin |4 aut | |
| 700 | 0 | |a STREAM investigators |e verfasserin |4 aut | |
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| 700 | 1 | |a Adgey, J |e investigator |4 oth | |
| 700 | 1 | |a Kendall, J |e investigator |4 oth | |
| 700 | 1 | |a Quinn, T |e investigator |4 oth | |
| 700 | 1 | |a Goldstein, P |e investigator |4 oth | |
| 700 | 1 | |a Steg, G |e investigator |4 oth | |
| 700 | 1 | |a Lambert, Y |e investigator |4 oth | |
| 700 | 1 | |a Huber, K |e investigator |4 oth | |
| 700 | 1 | |a Schreiber, W |e investigator |4 oth | |
| 700 | 1 | |a Piegas, L |e investigator |4 oth | |
| 700 | 1 | |a Carvalho, A |e investigator |4 oth | |
| 700 | 1 | |a Lopes, R D |e investigator |4 oth | |
| 700 | 1 | |a Zeymer, U |e investigator |4 oth | |
| 700 | 1 | |a Arntz, H |e investigator |4 oth | |
| 700 | 1 | |a Nanas, J |e investigator |4 oth | |
| 700 | 1 | |a Fresco, C |e investigator |4 oth | |
| 700 | 1 | |a Pesenti, A |e investigator |4 oth | |
| 700 | 1 | |a Aaberge, L |e investigator |4 oth | |
| 700 | 1 | |a Halvorsen, S |e investigator |4 oth | |
| 700 | 1 | |a Grajek, S |e investigator |4 oth | |
| 700 | 1 | |a Sulimov, V |e investigator |4 oth | |
| 700 | 1 | |a Ostojic, M |e investigator |4 oth | |
| 700 | 1 | |a Rosell, F |e investigator |4 oth | |
| 700 | 1 | |a Fox, K |e investigator |4 oth | |
| 700 | 1 | |a Montalescot, G |e investigator |4 oth | |
| 700 | 1 | |a Pollack, C |e investigator |4 oth | |
| 700 | 1 | |a Tijssen, J |e investigator |4 oth | |
| 700 | 1 | |a Weaver, D |e investigator |4 oth | |
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| 700 | 1 | |a Jagasia, P |e investigator |4 oth | |
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| 700 | 1 | |a Welsh, R |e investigator |4 oth | |
| 700 | 1 | |a Dianati Maleki, N |e investigator |4 oth | |
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| 700 | 1 | |a Regelin, A |e investigator |4 oth | |
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| 700 | 1 | |a Delbé, R |e investigator |4 oth | |
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| 700 | 1 | |a Mazzoleni, M |e investigator |4 oth | |
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| 700 | 1 | |a Kaff, A |e investigator |4 oth | |
| 700 | 1 | |a Malzer, R |e investigator |4 oth | |
| 700 | 1 | |a Sebald, D |e investigator |4 oth | |
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| 700 | 1 | |a Seidl, S |e investigator |4 oth | |
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| 700 | 1 | |a Pretsch, I |e investigator |4 oth | |
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