Relation Between Hospital Primary Angioplasty Volume and Mortality for Patients With Acute MI Treated With Primary Angioplasty vs Thrombolytic Therapy
CONTEXT Institutional experience with primary angioplasty has been suggested as a factor in selecting a reperfusion strategy for patients with acute myocardial infarction (AMI). However, no large studies have directly compared outcomes of primary angioplasty vs thrombolytic therapy as a function of...
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| Veröffentlicht in: | JAMA : the journal of the American Medical Association 2000-12, Vol.284 (24), p.3131-3138 |
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| creator | Magid, David J Calonge, B. Ned Rumsfeld, John S Canto, John G Frederick, Paul D Every, Nathan R Barron, Hal V for the National Registry of Myocardial Infarction 2 and 3 Investigators |
| description | CONTEXT Institutional experience with primary angioplasty has been suggested
as a factor in selecting a reperfusion strategy for patients with acute myocardial
infarction (AMI). However, no large studies have directly compared outcomes
of primary angioplasty vs thrombolytic therapy as a function of institutional
experience. OBJECTIVE To compare outcomes among patients with AMI who were treated with primary
angioplasty vs thrombolytic therapy at hospitals with different volumes of
primary angioplasty. DESIGN Retrospective cohort. SETTING A total of 446 acute care hospitals with 112 classified as low volume
(≤16 procedures), 223 as intermediate volume (17-48 procedures), and 111
as high volume (≥49 procedures) based on their annual primary angioplasty
volume. PATIENTS A total of 62 299 patients with AMI treated with primary angioplasty
or thrombolytic therapy from June 1, 1994, through July 31, 1999. MAIN OUTCOME MEASURE In-hospital mortality. RESULTS Mortality was lower among patients who received primary angioplasty
compared with those who received thrombolysis at hospitals with intermediate
volumes (4.5% vs 5.9%; P |
| doi_str_mv | 10.1001/jama.284.24.3131 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_72473995</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><ama_id>193408</ama_id><sourcerecordid>72473995</sourcerecordid><originalsourceid>FETCH-LOGICAL-a327t-54fe5a145ffccc98146297d067ccf21c223a1c558248ac6464376fc2c8c58cc03</originalsourceid><addsrcrecordid>eNpt0d9rFDEQB_AgFntW3_VFgoJve-bnJvt4FrWFFouc-rhM57I2x-5mTbLK_SP-vabcaaE0LyHDhy-ZGUJecLbkjPF3WxhgKaxaCrWUXPJHZMG1tJXUjX1MFow1tjLKqmPyNKUtK4dL84Qcc86lNqZekD9fXA_Zh5G-d_m3cyM9C2nyGXp6Ff0AcUdX4w8fph5S3tFvoZ8HR2Hc0MsQi_Kl2IVIr0qIG3Oi332-oSucs6OX53QdHWS32VcfCvyV6PomhuE69LvssTxchGn3jBx10Cf3_HCfkK8fP6xPz6qLz5_OT1cXFUhhcqVV5zRwpbsOERvLVS0as2G1QewERyEkcNTaCmUBa1UraeoOBVrUFpHJE_J2nzvF8HN2KbeDT-j6HkYX5tQaoYxsGl3g63twG-Y4lr-14naYvK5v0asDmq8Ht2mnfcPtv3EX8OYAICH0XYQRffrvrC7MFvVyr8p27zIaqZiVfwEJG5jE</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>211351665</pqid></control><display><type>article</type><title>Relation Between Hospital Primary Angioplasty Volume and Mortality for Patients With Acute MI Treated With Primary Angioplasty vs Thrombolytic Therapy</title><source>MEDLINE</source><source>American Medical Association Journals</source><creator>Magid, David J ; Calonge, B. Ned ; Rumsfeld, John S ; Canto, John G ; Frederick, Paul D ; Every, Nathan R ; Barron, Hal V ; for the National Registry of Myocardial Infarction 2 and 3 Investigators</creator><creatorcontrib>Magid, David J ; Calonge, B. Ned ; Rumsfeld, John S ; Canto, John G ; Frederick, Paul D ; Every, Nathan R ; Barron, Hal V ; for the National Registry of Myocardial Infarction 2 and 3 Investigators ; National Registry of Myocardial Infarction 2 and 3 Investigators</creatorcontrib><description>CONTEXT Institutional experience with primary angioplasty has been suggested
as a factor in selecting a reperfusion strategy for patients with acute myocardial
infarction (AMI). However, no large studies have directly compared outcomes
of primary angioplasty vs thrombolytic therapy as a function of institutional
experience. OBJECTIVE To compare outcomes among patients with AMI who were treated with primary
angioplasty vs thrombolytic therapy at hospitals with different volumes of
primary angioplasty. DESIGN Retrospective cohort. SETTING A total of 446 acute care hospitals with 112 classified as low volume
(≤16 procedures), 223 as intermediate volume (17-48 procedures), and 111
as high volume (≥49 procedures) based on their annual primary angioplasty
volume. PATIENTS A total of 62 299 patients with AMI treated with primary angioplasty
or thrombolytic therapy from June 1, 1994, through July 31, 1999. MAIN OUTCOME MEASURE In-hospital mortality. RESULTS Mortality was lower among patients who received primary angioplasty
compared with those who received thrombolysis at hospitals with intermediate
volumes (4.5% vs 5.9%; P<.001) and high volumes
(3.4% vs 5.4%; P<.001) of primary angioplasty.
At low-volume hospitals, there was no significant difference in mortality
between patients treated with primary angioplasty vs those treated with thrombolysis
(6.2% vs 5.9%; P = .58). Adjusting for differences
in demographic, medical history, clinical presentation, treatment, and hospital
characteristics did not significantly alter these findings. CONCLUSIONS In this study, patients with AMI treated at hospitals with high or intermediate
volumes of primary angioplasty had lower mortality with primary angioplasty
than with thrombolysis, whereas patients with AMI treated at hospitals with
low angioplasty volumes had similar mortality outcomes with primary angioplasty
or thrombolysis.</description><identifier>ISSN: 0098-7484</identifier><identifier>EISSN: 1538-3598</identifier><identifier>DOI: 10.1001/jama.284.24.3131</identifier><identifier>PMID: 11135776</identifier><identifier>CODEN: JAMAAP</identifier><language>eng</language><publisher>Chicago, IL: American Medical Association</publisher><subject>Aged ; Angioplasty ; Angioplasty, Balloon, Coronary - statistics & numerical data ; Biological and medical sciences ; Cardiology ; Cardiology Service, Hospital - standards ; Cardiology Service, Hospital - statistics & numerical data ; Cardiology. Vascular system ; Clinical outcomes ; Coronary heart disease ; Female ; Heart ; Heart attacks ; Hospital Mortality ; Hospitals - standards ; Hospitals - statistics & numerical data ; Humans ; Male ; Medical sciences ; Middle Aged ; Mortality ; Myocardial Infarction - mortality ; Myocardial Infarction - therapy ; Outcome and Process Assessment (Health Care) ; Retrospective Studies ; Surgery Department, Hospital - standards ; Surgery Department, Hospital - statistics & numerical data ; Thrombolytic Therapy - statistics & numerical data ; United States - epidemiology</subject><ispartof>JAMA : the journal of the American Medical Association, 2000-12, Vol.284 (24), p.3131-3138</ispartof><rights>2001 INIST-CNRS</rights><rights>Copyright American Medical Association Dec 27, 2000</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a327t-54fe5a145ffccc98146297d067ccf21c223a1c558248ac6464376fc2c8c58cc03</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://jamanetwork.com/journals/jama/articlepdf/10.1001/jama.284.24.3131$$EPDF$$P50$$Gama$$H</linktopdf><linktohtml>$$Uhttps://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.284.24.3131$$EHTML$$P50$$Gama$$H</linktohtml><link.rule.ids>64,314,776,780,3327,27901,27902,76231,76234</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=853578$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11135776$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Magid, David J</creatorcontrib><creatorcontrib>Calonge, B. Ned</creatorcontrib><creatorcontrib>Rumsfeld, John S</creatorcontrib><creatorcontrib>Canto, John G</creatorcontrib><creatorcontrib>Frederick, Paul D</creatorcontrib><creatorcontrib>Every, Nathan R</creatorcontrib><creatorcontrib>Barron, Hal V</creatorcontrib><creatorcontrib>for the National Registry of Myocardial Infarction 2 and 3 Investigators</creatorcontrib><creatorcontrib>National Registry of Myocardial Infarction 2 and 3 Investigators</creatorcontrib><title>Relation Between Hospital Primary Angioplasty Volume and Mortality for Patients With Acute MI Treated With Primary Angioplasty vs Thrombolytic Therapy</title><title>JAMA : the journal of the American Medical Association</title><addtitle>JAMA</addtitle><description>CONTEXT Institutional experience with primary angioplasty has been suggested
as a factor in selecting a reperfusion strategy for patients with acute myocardial
infarction (AMI). However, no large studies have directly compared outcomes
of primary angioplasty vs thrombolytic therapy as a function of institutional
experience. OBJECTIVE To compare outcomes among patients with AMI who were treated with primary
angioplasty vs thrombolytic therapy at hospitals with different volumes of
primary angioplasty. DESIGN Retrospective cohort. SETTING A total of 446 acute care hospitals with 112 classified as low volume
(≤16 procedures), 223 as intermediate volume (17-48 procedures), and 111
as high volume (≥49 procedures) based on their annual primary angioplasty
volume. PATIENTS A total of 62 299 patients with AMI treated with primary angioplasty
or thrombolytic therapy from June 1, 1994, through July 31, 1999. MAIN OUTCOME MEASURE In-hospital mortality. RESULTS Mortality was lower among patients who received primary angioplasty
compared with those who received thrombolysis at hospitals with intermediate
volumes (4.5% vs 5.9%; P<.001) and high volumes
(3.4% vs 5.4%; P<.001) of primary angioplasty.
At low-volume hospitals, there was no significant difference in mortality
between patients treated with primary angioplasty vs those treated with thrombolysis
(6.2% vs 5.9%; P = .58). Adjusting for differences
in demographic, medical history, clinical presentation, treatment, and hospital
characteristics did not significantly alter these findings. CONCLUSIONS In this study, patients with AMI treated at hospitals with high or intermediate
volumes of primary angioplasty had lower mortality with primary angioplasty
than with thrombolysis, whereas patients with AMI treated at hospitals with
low angioplasty volumes had similar mortality outcomes with primary angioplasty
or thrombolysis.</description><subject>Aged</subject><subject>Angioplasty</subject><subject>Angioplasty, Balloon, Coronary - statistics & numerical data</subject><subject>Biological and medical sciences</subject><subject>Cardiology</subject><subject>Cardiology Service, Hospital - standards</subject><subject>Cardiology Service, Hospital - statistics & numerical data</subject><subject>Cardiology. Vascular system</subject><subject>Clinical outcomes</subject><subject>Coronary heart disease</subject><subject>Female</subject><subject>Heart</subject><subject>Heart attacks</subject><subject>Hospital Mortality</subject><subject>Hospitals - standards</subject><subject>Hospitals - statistics & numerical data</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Myocardial Infarction - mortality</subject><subject>Myocardial Infarction - therapy</subject><subject>Outcome and Process Assessment (Health Care)</subject><subject>Retrospective Studies</subject><subject>Surgery Department, Hospital - standards</subject><subject>Surgery Department, Hospital - statistics & numerical data</subject><subject>Thrombolytic Therapy - statistics & numerical data</subject><subject>United States - epidemiology</subject><issn>0098-7484</issn><issn>1538-3598</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpt0d9rFDEQB_AgFntW3_VFgoJve-bnJvt4FrWFFouc-rhM57I2x-5mTbLK_SP-vabcaaE0LyHDhy-ZGUJecLbkjPF3WxhgKaxaCrWUXPJHZMG1tJXUjX1MFow1tjLKqmPyNKUtK4dL84Qcc86lNqZekD9fXA_Zh5G-d_m3cyM9C2nyGXp6Ff0AcUdX4w8fph5S3tFvoZ8HR2Hc0MsQi_Kl2IVIr0qIG3Oi332-oSucs6OX53QdHWS32VcfCvyV6PomhuE69LvssTxchGn3jBx10Cf3_HCfkK8fP6xPz6qLz5_OT1cXFUhhcqVV5zRwpbsOERvLVS0as2G1QewERyEkcNTaCmUBa1UraeoOBVrUFpHJE_J2nzvF8HN2KbeDT-j6HkYX5tQaoYxsGl3g63twG-Y4lr-14naYvK5v0asDmq8Ht2mnfcPtv3EX8OYAICH0XYQRffrvrC7MFvVyr8p27zIaqZiVfwEJG5jE</recordid><startdate>20001227</startdate><enddate>20001227</enddate><creator>Magid, David J</creator><creator>Calonge, B. Ned</creator><creator>Rumsfeld, John S</creator><creator>Canto, John G</creator><creator>Frederick, Paul D</creator><creator>Every, Nathan R</creator><creator>Barron, Hal V</creator><creator>for the National Registry of Myocardial Infarction 2 and 3 Investigators</creator><general>American Medical Association</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7QL</scope><scope>7QP</scope><scope>7TK</scope><scope>7TS</scope><scope>7U7</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope></search><sort><creationdate>20001227</creationdate><title>Relation Between Hospital Primary Angioplasty Volume and Mortality for Patients With Acute MI Treated With Primary Angioplasty vs Thrombolytic Therapy</title><author>Magid, David J ; Calonge, B. Ned ; Rumsfeld, John S ; Canto, John G ; Frederick, Paul D ; Every, Nathan R ; Barron, Hal V ; for the National Registry of Myocardial Infarction 2 and 3 Investigators</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a327t-54fe5a145ffccc98146297d067ccf21c223a1c558248ac6464376fc2c8c58cc03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Aged</topic><topic>Angioplasty</topic><topic>Angioplasty, Balloon, Coronary - statistics & numerical data</topic><topic>Biological and medical sciences</topic><topic>Cardiology</topic><topic>Cardiology Service, Hospital - standards</topic><topic>Cardiology Service, Hospital - statistics & numerical data</topic><topic>Cardiology. Vascular system</topic><topic>Clinical outcomes</topic><topic>Coronary heart disease</topic><topic>Female</topic><topic>Heart</topic><topic>Heart attacks</topic><topic>Hospital Mortality</topic><topic>Hospitals - standards</topic><topic>Hospitals - statistics & numerical data</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Myocardial Infarction - mortality</topic><topic>Myocardial Infarction - therapy</topic><topic>Outcome and Process Assessment (Health Care)</topic><topic>Retrospective Studies</topic><topic>Surgery Department, Hospital - standards</topic><topic>Surgery Department, Hospital - statistics & numerical data</topic><topic>Thrombolytic Therapy - statistics & numerical data</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Magid, David J</creatorcontrib><creatorcontrib>Calonge, B. Ned</creatorcontrib><creatorcontrib>Rumsfeld, John S</creatorcontrib><creatorcontrib>Canto, John G</creatorcontrib><creatorcontrib>Frederick, Paul D</creatorcontrib><creatorcontrib>Every, Nathan R</creatorcontrib><creatorcontrib>Barron, Hal V</creatorcontrib><creatorcontrib>for the National Registry of Myocardial Infarction 2 and 3 Investigators</creatorcontrib><creatorcontrib>National Registry of Myocardial Infarction 2 and 3 Investigators</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Physical Education Index</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>JAMA : the journal of the American Medical Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Magid, David J</au><au>Calonge, B. Ned</au><au>Rumsfeld, John S</au><au>Canto, John G</au><au>Frederick, Paul D</au><au>Every, Nathan R</au><au>Barron, Hal V</au><au>for the National Registry of Myocardial Infarction 2 and 3 Investigators</au><aucorp>National Registry of Myocardial Infarction 2 and 3 Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Relation Between Hospital Primary Angioplasty Volume and Mortality for Patients With Acute MI Treated With Primary Angioplasty vs Thrombolytic Therapy</atitle><jtitle>JAMA : the journal of the American Medical Association</jtitle><addtitle>JAMA</addtitle><date>2000-12-27</date><risdate>2000</risdate><volume>284</volume><issue>24</issue><spage>3131</spage><epage>3138</epage><pages>3131-3138</pages><issn>0098-7484</issn><eissn>1538-3598</eissn><coden>JAMAAP</coden><abstract>CONTEXT Institutional experience with primary angioplasty has been suggested
as a factor in selecting a reperfusion strategy for patients with acute myocardial
infarction (AMI). However, no large studies have directly compared outcomes
of primary angioplasty vs thrombolytic therapy as a function of institutional
experience. OBJECTIVE To compare outcomes among patients with AMI who were treated with primary
angioplasty vs thrombolytic therapy at hospitals with different volumes of
primary angioplasty. DESIGN Retrospective cohort. SETTING A total of 446 acute care hospitals with 112 classified as low volume
(≤16 procedures), 223 as intermediate volume (17-48 procedures), and 111
as high volume (≥49 procedures) based on their annual primary angioplasty
volume. PATIENTS A total of 62 299 patients with AMI treated with primary angioplasty
or thrombolytic therapy from June 1, 1994, through July 31, 1999. MAIN OUTCOME MEASURE In-hospital mortality. RESULTS Mortality was lower among patients who received primary angioplasty
compared with those who received thrombolysis at hospitals with intermediate
volumes (4.5% vs 5.9%; P<.001) and high volumes
(3.4% vs 5.4%; P<.001) of primary angioplasty.
At low-volume hospitals, there was no significant difference in mortality
between patients treated with primary angioplasty vs those treated with thrombolysis
(6.2% vs 5.9%; P = .58). Adjusting for differences
in demographic, medical history, clinical presentation, treatment, and hospital
characteristics did not significantly alter these findings. CONCLUSIONS In this study, patients with AMI treated at hospitals with high or intermediate
volumes of primary angioplasty had lower mortality with primary angioplasty
than with thrombolysis, whereas patients with AMI treated at hospitals with
low angioplasty volumes had similar mortality outcomes with primary angioplasty
or thrombolysis.</abstract><cop>Chicago, IL</cop><pub>American Medical Association</pub><pmid>11135776</pmid><doi>10.1001/jama.284.24.3131</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0098-7484 |
| ispartof | JAMA : the journal of the American Medical Association, 2000-12, Vol.284 (24), p.3131-3138 |
| issn | 0098-7484 1538-3598 |
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| source | MEDLINE; American Medical Association Journals |
| subjects | Aged Angioplasty Angioplasty, Balloon, Coronary - statistics & numerical data Biological and medical sciences Cardiology Cardiology Service, Hospital - standards Cardiology Service, Hospital - statistics & numerical data Cardiology. Vascular system Clinical outcomes Coronary heart disease Female Heart Heart attacks Hospital Mortality Hospitals - standards Hospitals - statistics & numerical data Humans Male Medical sciences Middle Aged Mortality Myocardial Infarction - mortality Myocardial Infarction - therapy Outcome and Process Assessment (Health Care) Retrospective Studies Surgery Department, Hospital - standards Surgery Department, Hospital - statistics & numerical data Thrombolytic Therapy - statistics & numerical data United States - epidemiology |
| title | Relation Between Hospital Primary Angioplasty Volume and Mortality for Patients With Acute MI Treated With Primary Angioplasty vs Thrombolytic Therapy |
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