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Is PCI Safe, Effective After Clot-Busters for Heart Attack?
Date:3/30/2008

MD, medical director of the interventional and invasive program at Southlake Regional Health Centre, Newmarket, Ontario, Canada. "It's an important question, because more than 75 percent of hospitals in North America don't have PCI facilities."

TRANSFER-AMI is the largest-ever randomized trial to investigate this question. For the study, Dr. Cantor and his colleagues enrolled 1,060 high-risk patients with either a large or complicated heart attack, also known as ST-segment-elevation myocardial infarction (STEMI). All patients initially sought treatment at a hospital without PCI capability and were treated with tenecteplase, a clot-busting drug. Patients were then randomly assigned to urgent transfer for PCI within six hours, or to standard therapy, consisting of observation for 60 to 90 minutes, with transfer for PCI only in the case of continuing chest pain or other evidence of treatment failure.

The study will evaluate 30-day combined rates of death, repeat heart attack, recurring ischemia, heart failure and shock in the two groups of patients.

"Many hospitals have difficulty getting patients to the cath lab within the recommended 90 minutes, but six hours is a much more realistic goal," Dr. Cantor said. "If routine PCI is clearly superior to standard therapy in the TRANSFER-AMI trial, then all institutions that use thrombolysis for treating STEMI will need to develop strategies to get those patients to a cardiac catheterization laboratory within six hours."

Dr. Cantor will present the results of the "Trial of Routine Angioplasty and Stenting After Fibrinolysis to Enhance Reperfusion in Acute Myocardial Infarction" (TRANSFER-AMI) study on Sunday, March 30 at 8:45 a.m. CDT in the Grand Ballroom, S100.

About SCAI

Headquartered in Washington, DC, the Society for Cardiovascular Angiography and Interventions is a 4,000-member professional organization representing invasive and interventional cardiologists in over 60 nations. SC
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