16 Years of Superiority of Primary Angioplasty

The DANish Acute Myocardial Infarction 2 (DANAMI-2) trial showed the 30-day superiority of patient transport to a primary angioplasty site vs. fibrinolysis at the hospital where the patient had been originally admitted. Those 30-day results became a landmark in the history of interventional cardiology. However, some suspected that such initial benefit could fade away over time.

16 años de superioridad de la angioplastia primaria

Now, with the results of the 16-year follow-up, we know that this benefit is maintained “indefinitely.”

DANAMI-2 randomized 1572 patients with ST-segment elevation acute coronary syndrome to primary angioplasty vs. fibrinolysis at 24 referral hospitals, 5 of which offered primary angioplasty. Patients in the primary angioplasty arm were immediately transferred to the nearest invasive center, while the other arm received fibrinolysis at the hospital where its patients first sought attention.


Read also: Virtual ACC 2020 | More Evidence in Support of the Demanding 2017 Hypertension Guidelines.


After 16 years of follow-up, patients who underwent primary angioplasty had better results in terms of the primary endpoint compared with patients treated with fibrinolysis (58.7% vs. 62.3%; hazard ratio [HR]: 0.86). In patients who were transported to undergo primary angioplasty, their benefit was similar to that of the general population (58.7% vs. 64.1%; HR: 0.82).

There were no differences in all-cause mortality, but cardiovascular mortality was reduced by 4.4% in absolute terms, in favor of angioplasty.


Read also: Virtual ACC 2020 | COAPT: Better Quality of Life Translates into Harder End-Points.


Angioplasty managed to postpone a major event by over a year, compared with fibrinolysis.

Conclusion

The benefit of primary angioplasty compared with fibrinolysis is maintained after 16 years of follow-up. Primary angioplasty was superior as regards a reduction in the combined endpoint of death, cardiovascular death, and reinfarction. It reduced the rates for those events and it also postponed events by over a year.

oup-accepted-manuscript-2019

Original Title: 16-year follow-up of the Danish Acute Myocardial Infarction 2 (DANAMI-2) trial: primary percutaneous coronary intervention vs. fibrinolysisinST-segmentelevationmyocardial infarction.

Reference: Pernille G. Thrane et al. European Heart Journal. Article in press.


Subscribe to our weekly newsletter

Get the latest scientific articles on interventional cardiology

We are interested in your opinion. Please, leave your comments, thoughts, questions, etc., below. They will be most welcome.

More articles by this author

TCT 2024 | FAVOR III EUROPA

The study FAVOR III EUROPA, a randomized trial, included 2,000 patients with chronic coronary syndrome, or stabilized acute coronary syndrome, and intermediate lesions. 1,008...

TCT 2024 – ECLIPSE: Randomized Study of Orbital Atherectomy vs Conventional PCI in Severely Calcified Lesions

Coronary calcification is associated with stent under-expansion and increased risk of both early and late adverse events. Atherectomy is an essential tool for uncrossable...

TCT 2024 | Use of Drug-Coated Balloons for Side Branch Treatment in Provisional Stenting

In some cases, treating coronary bifurcations with provisional stenting requires side branch stenting, which may lead to suboptimal outcomes. Drug-coated balloons (DCBs) have emerged...

TCT 2024 | Use of Artificial Intelligence for Patients with Suspected Coronary Artery Disease

The current approach to chest pain mainly focuses on symptom characteristics, conducting functional tests for ischemia assessment. However, several randomized clinical trials have shown...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

TCT 2024 | FAVOR III EUROPA

The study FAVOR III EUROPA, a randomized trial, included 2,000 patients with chronic coronary syndrome, or stabilized acute coronary syndrome, and intermediate lesions. 1,008...

TCT 2024 | TRISCEND II

This randomized study included 400 patients; 267 were treated with EVOQUE valve and 133 with optimal medical treatment (OMT). After one-year follow-up, there were no...

TCT 2024 – ACCESS-TAVI: Comparing Percutaneous Access Closure Strategies After TAVI

Vascular access complications following transcatheter aortic valve implantation (TAVI) remain common. However, few studies compare vascular access closure methods.  Based on the CHOICE-CLOSURE and MASH...