FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Volume 335:1253-1260 October 24, 1996 Number 17 Next

	Full Text PDF Letters Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background Several relatively small randomized trials have shown that primary angioplasty results in a better short-term outcome than thrombolytic therapy in patients with acute myocardial infarction. These results, however, have not been duplicated other than in investigational trials.

Methods We compared mortality during hospitalization and long-term mortality, as well as the use of resources, among 1050 patients in a primary-angioplasty group and 2095 patients in a thrombolytic-therapy group. Patients were selected from the Myocardial Infarction Triage and Intervention Project Registry cohort of 12,331 consecutive patients admitted with acute myocardial infarction to 19 Seattle hospitals between 1988 and 1994. Because of the potential for selection bias, several subgroup analyses were performed that included patients eligible for thrombolysis, high-risk patients, and patients in the primary-angioplasty group who were treated at hospitals with high volumes of angioplasty.

Results There was no significant difference in mortality during hospitalization or long-term follow-up between patients in the thrombolytic-therapy group and those in the primary-angioplasty group (mortality during hospitalization, 5.6 percent and 5.5 percent, respectively; P = 0.93; adjusted hazard ratio for the risk of death within three years after primary angioplasty, 0.95; 95 percent confidence interval, 0.8 to 1.2). There was also no significant difference in mortality between high-risk subgroups of patients in the two treatment groups. The rates of procedures and costs were lower among patients in the thrombolytic-therapy group both at the time of hospital discharge and after three years of follow-up (30 percent fewer coronary angiograms, 15 percent fewer coronary angioplasties, and 13 percent lower costs after three years of follow-up).

Conclusions In a community setting, we observed no benefit in terms of either mortality or the use of resources with a strategy of primary angioplasty rather than thrombolytic therapy in a large cohort of patients with acute myocardial infarction.

Source Information

From the Northwest Health Services Research and Development Field Program, Seattle Veterans Affairs Medical Center, Seattle (N.R.E.); the Department of Health Policy, Stanford University, Stanford, Calif. (M.H.); and the Myocardial Infarction Triage and Intervention Project, Division of Cardiology, University of Washington, Seattle (L.S.P., J.S.M., W.D.W.).

Address reprint requests to Dr. Every at the MITI Coordinating Center, 1910 Fairview Ave. E., Ste. 205, Seattle, WA 98102.

Full Text of this Article

Related Letters:

Thrombolysis or Primary Angioplasty for Acute Myocardial Infarction?
Zijlstra F., Hoorntje J. C.A., de Boer M.-J., Magalski A., O'Keefe J. H., Leff B., Lange R. A., Hillis L. D., Grines C. L.
Extract | Full Text  
N Engl J Med 1997; 336:1101-1103, Apr 10, 1997. Correspondence

A Comparison of Thrombolytic Therapy with Primary Coronary Angioplasty for Acute Myocardial Infarction
Lee J. S., Fath-Ordoubadi F., Beatt K. J., Every N. R., Weaver W. D.
Extract | Full Text  
N Engl J Med 1997; 336:1103-1104, Apr 10, 1997. Correspondence

This article has been cited by other articles:

• Pride, Y. B., Canto, J. G., Frederick, P. D., Gibson, C. M., for the NRMI Investigators, (2009). Outcomes Among Patients With ST-Segment-Elevation Myocardial Infarction Presenting to Interventional Hospitals With and Without On-Site Cardiac Surgery. Circ Cardiovasc Qual Outcomes 2: 574-582 [Abstract] [Full Text]  
• Huynh, T., Perron, S., O'Loughlin, J., Joseph, L., Labrecque, M., Tu, J. V., Theroux, P. (2009). Comparison of Primary Percutaneous Coronary Intervention and Fibrinolytic Therapy in ST-Segment-Elevation Myocardial Infarction: Bayesian Hierarchical Meta-Analyses of Randomized Controlled Trials and Observational Studies. Circulation 119: 3101-3109 [Abstract] [Full Text]  
• Bates, E. R., Nallamothu, B. K. (2008). Commentary: The Role of Percutaneous Coronary Intervention in ST-Segment-Elevation Myocardial Infarction. Circulation 118: 567-573 [Full Text]  
• Danchin, N., Coste, P., Ferrieres, J., Steg, P.-G., Cottin, Y., Blanchard, D., Belle, L., Ritz, B., Kirkorian, G., Angioi, M., Sans, P., Charbonnier, B., Eltchaninoff, H., Gueret, P., Khalife, K., Asseman, P., Puel, J., Goldstein, P., Cambou, J.-P., Simon, T., for the FAST-MI Investigators, (2008). Comparison of Thrombolysis Followed by Broad Use of Percutaneous Coronary Intervention With Primary Percutaneous Coronary Intervention for ST-Segment-Elevation Acute Myocardial Infarction: Data From the French Registry on Acute ST-Elevation Myocardial Infarction (FAST-MI). Circulation 118: 268-276 [Abstract] [Full Text]  
• Boersma, E., The Primary Coronary Angioplasty vs. Thrombolysis, (2006). Does time matter? A pooled analysis of randomized clinical trials comparing primary percutaneous coronary intervention and in-hospital fibrinolysis in acute myocardial infarction patients. Eur Heart J 27: 779-788 [Abstract] [Full Text]  
• Henriques, J P S, Zijlstra, F, van 't Hof, A W J, de Boer, M-J, Dambrink, J-H E, Gosselink, A T M, Hoorntje, J C A, Ottervanger, J P, Suryapranata, H (2006). Primary percutaneous coronary intervention versus thrombolytic treatment: long term follow up according to infarct location. Heart 92: 75-79 [Abstract] [Full Text]  
• Huber, K., Caterina, R. D., Kristensen, S. D., Verheugt, F. W.A., Montalescot, G., Maestro, L. B., Werf, F. V. d., for the Task Force on Pre-hospital Reperfusion The, (2005). Pre-hospital reperfusion therapy: a strategy to improve therapeutic outcome in patients with ST-elevation myocardial infarction. Eur Heart J 26: 2063-2074 [Full Text]  
• Fassa, A-A, Urban, P, Radovanovic, D, Duvoisin, N, Gaspoz, J-M, Stauffer, J-C, Erne, P, for the AMIS Plus Investigators, (2005). Trends in reperfusion therapy of ST segment elevation myocardial infarction in Switzerland: six year results from a nationwide registry. Heart 91: 882-888 [Abstract] [Full Text]  
• Namiuchi, S., Kagaya, Y., Ohta, J., Shiba, N., Sugi, M., Oikawa, M., Kunii, H., Yamao, H., Komatsu, N., Yui, M., Tada, H., Sakuma, M., Watanabe, J., Ichihara, T., Shirato, K. (2005). High Serum Erythropoietin Level Is Associated With Smaller Infarct Size in Patients With Acute Myocardial Infarction Who Undergo Successful Primary Percutaneous Coronary Intervention. J Am Coll Cardiol 45: 1406-1412 [Abstract] [Full Text]  
• Machecourt, J., Bonnefoy, E., Vanzetto, G., Motreff, P., Marliere, S., Leizorovicz, A., Allenet, B., Lacroute, J. M., Cassagnes, J., Touboul, P. (2005). Primary angioplasty is cost-minimizing compared with pre-hospital thrombolysis for patients within 60 min of a percutaneous coronary intervention center: The Comparison of Angioplasty and Pre-hospital Thrombolysis in Acute Myocardial Infarction (CAPTIM) cost-efficacy sub-study. J Am Coll Cardiol 45: 515-524 [Abstract] [Full Text]  
• Danchin, N., Blanchard, D., Steg, P. G., Sauval, P., Hanania, G., Goldstein, P., Cambou, J.-P., Gueret, P., Vaur, L., Boutalbi, Y., Genes, N., Lablanche, J.-M., for the USIC 2000 Investigators, (2004). Impact of Prehospital Thrombolysis for Acute Myocardial Infarction on 1-Year Outcome: Results From the French Nationwide USIC 2000 Registry. Circulation 110: 1909-1915 [Abstract] [Full Text]  
• Writing Committee Members, , Antman, E. M., Anbe, D. T., Armstrong, P. W., Bates, E. R., Green, L. A., Hand, M., Hochman, J. S., Krumholz, H. M., Kushner, F. G., Lamas, G. A., Mullany, C. J., Ornato, J. P., Pearle, D. L., Sloan, M. A., Smith, S. C. Jr, Task Force Members, , Antman, E. M., Smith, S. C. Jr, Alpert, J. S., Anderson, J. L., Faxon, D. P., Fuster, V., Gibbons, R. J., Gregoratos, G., Halperin, J. L., Hiratzka, L. F., Hunt, S. A., Jacobs, A. K., Ornato, J. P. (2004). ACC/AHA guidelines for the management of patients with ST-Elevation myocardial infarction--executive summary: A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (writing committee to revise the 1999 guidelines for the management of patients with acute myocardial infarction) . J Am Coll Cardiol 44: 671-719 [Full Text]  
• Antman, E. M., Anbe, D. T., Armstrong, P. W., Bates, E. R., Green, L. A., Hand, M., Hochman, J. S., Krumholz, H. M., Kushner, F. G., Lamas, G. A., Mullany, C. J., Ornato, J. P., Pearle, D. L., Sloan, M. A., Smith, S. C. Jr, Antman, E. M., Smith, S. C. Jr, Alpert, J. S., Anderson, J. L., Faxon, D. P., Fuster, V., Gibbons, R. J., Gregoratos, G., Halperin, J. L., Hiratzka, L. F., Hunt, S. A., Jacobs, A. K., Ornato, J. P. (2004). ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction--Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction). Circulation 110: 588-636 [Full Text]  
• Pechlaner, C., Bellmann, R., Yee, A., Gabayan, A., Carbajal, E. V., Aversano, T. (2002). Thrombolytic Therapy vs Angioplasty in Acute Myocardial Infarction. JAMA 288: 2263-2264 [Full Text]  
• Klein, L. W., Block, P., Brindis, R. G., McKay, C. R., McCallister, B. D., Wolk, M., Weintraub, W., ACC-NCDR Registry, (2002). Percutaneous coronary interventions in octogenarians in the American College of Cardiology-National Cardiovascular Data Registry: Development of a nomogram predictive of in-hospital mortality. J Am Coll Cardiol 40: 394-402 [Abstract] [Full Text]  
• Selker, H. P., Beshansky, J. R., Griffith, J. L., for the TPI Trial Investigators*, (2002). Use of the Electrocardiograph-Based Thrombolytic Predictive Instrument To Assist Thrombolytic and Reperfusion Therapy for Acute Myocardial Infarction: A Multicenter, Randomized, Controlled, Clinical Effectiveness Trial. ANN INTERN MED 137: 87-95 [Abstract] [Full Text]  
• Singh, M., Ting, H. H., Berger, P. B., Garratt, K. N., Holmes, D. R. Jr, Gersh, B. J. (2002). Rationale for on-site cardiac surgery for primary angioplasty: a time for reappraisal. J Am Coll Cardiol 39: 1881-1889 [Abstract] [Full Text]  
• Cannon, C. P., Baim, D. S. (2002). Expanding the reach of primary percutaneous coronary intervention for the treatment of acute myocardial infarction. J Am Coll Cardiol 39: 1720-1722 [Full Text]  
• Cohen, V., Murphy, D. G., Williams, J. (2002). Review of the Current ACS Practice Guideline to Develop an Ischemic Chest Pain Protocol. Journal of Pharmacy Practice 15: 250-266 [Abstract]  
• Cannon, C. P. (2002). Primary Percutaneous Coronary Intervention for All?. JAMA 287: 1987-1989 [Full Text]  
• McNeil, B. J. (2001). Hidden Barriers to Improvement in the Quality of Care. NEJM 345: 1612-1620 [Full Text]  
• Vakili, B. A., Kaplan, R., Brown, D. L. (2001). Volume-Outcome Relation for Physicians and Hospitals Performing Angioplasty for Acute Myocardial Infarction in New York State. Circulation 104: 2171-2176 [Abstract] [Full Text]  
• Butler, J., Ness, R., Speroff, T. (2001). Improving Care for Elderly Patients With Peptic Ulcer Disease: Should the Focus Be on Drugs or Bugs?. JAMA 286: 2023-2024 [Full Text]  
• HAMPTON, J. (2001). Immediate angioplasty for the National Health Service?. Heart 86: 241-242 [Full Text]  
• Smith, S. C. Jr, Dove, J. T., Jacobs, A. K., Ward Kennedy, J., Kereiakes, D., Kern, M. J., Kuntz, R. E., Popma, J. J., Schaff, H. V., Williams, D. O., Gibbons, R. J., Alpert, J. P., Eagle, K. A., Faxon, D. P., Fuster, V., Gardner, T. J., Gregoratos, G., Russell, R. O., Smith, S. C. Jr (2001). ACC/AHA guidelines for percutaneous coronary intervention (revision of the 1993 PTCA guidelines): A report of the American College of Cardiology/ American Heart Association Task Force on practice guidelines (Committee to revise the 1993 guidelines for percutaneous transluminal coronary angioplasty) endorsed by the Society for Cardiac Angiography and Interventions. J Am Coll Cardiol 37: 2239-2239 [Full Text]  
• Zahn, R., Schiele, R., Schneider, S., Gitt, A. K., Wienbergen, H., Seidl, K., Voigtlander, T., Gottwik, M., Berg, G., Altmann, E., Rosahl, W., Senges, J., for the Maximal Individual Therapy in Acute Myocar, (2001). Primary angioplasty versus intravenous thrombolysis in acute myocardial infarction: can we define subgroups of patients benefiting most from primary angioplasty?: Results from the pooled data of the maximal individual therapy in acute myocardial infarction registry and the myocardial infarction registry. J Am Coll Cardiol 37: 1827-1835 [Abstract] [Full Text]  
• Every, N. R., Lehmann, K. G. (2001). The effectiveness of primary PTCA: does patient risk matter?. J Am Coll Cardiol 37: 1836-1838 [Full Text]  
• Verdu-Pascual, F., Castello-Ponce, A. (2001). Randomised clinical trials: a source of ethical dilemmas. J. Med. Ethics 27: 177-178 [Abstract] [Full Text]  
• Larson, E. B. (2001). General Internal Medicine at the Crossroads of Prosperity and Despair: Caring for Patients with Chronic Diseases in an Aging Society. ANN INTERN MED 134: 997-1000 [Abstract] [Full Text]  
• Herrmann, H.C., Li, R.H., Ohman, E.M. (2001). Facilitated percutaneous coronary intervention: results from the SPEED trial. Eur Heart J Suppl 3: A26-A34 [Abstract]  
• Magid, D. J., Calonge, B. N., Rumsfeld, J. S., Canto, J. G., Frederick, P. D., Every, N. R., Barron, H. V., for the National Registry of Myocardial Infarction, (2000). Relation Between Hospital Primary Angioplasty Volume and Mortality for Patients With Acute MI Treated With Primary Angioplasty vs Thrombolytic Therapy. JAMA 284: 3131-3138 [Abstract] [Full Text]  
• Williams, D. O., Holubkov, R., Yeh, W., Bourassa, M. G., Al-Bassam, M., Block, P. C., Coady, P., Cohen, H., Cowley, M., Dorros, G., Faxon, D., Holmes, D. R., Jacobs, A., Kelsey, S. F., King, S. B. III, Myler, R., Slater, J., Stanek, V., Vlachos, H. A., Detre, K. M. (2000). Percutaneous Coronary Intervention in the Current Era Compared With 1985-1986 : The National Heart, Lung, and Blood Institute Registries. Circulation 102: 2945-2951 [Abstract] [Full Text]  
• Zahn, R., Schiele, R., Schneider, S., Gitt, A. K., Wienbergen, H., Seidl, K., Bossaller, C., Buttner, H. J., Gottwik, M., Altmann, E., Rosahl, W., Senges, J., for the Maximal Individual Therapy in Acute Myocar, (2000). Decreasing hospital mortality between 1994 and 1998 in patients with acute myocardial infarction treated with primary angioplasty but not in patients treated with intravenous thrombolysis: Results from the pooled data of the maximal individual therapy in acute myocardial infarction (MITRA) registry and the myocardial infarction registry (MIR). J Am Coll Cardiol 36: 2064-2071 [Abstract] [Full Text]  
• Herrmann, H. C., Moliterno, D. J., Ohman, E. M., Stebbins, A. L., Bode, C., Betriu, A., Forycki, F., Miklin, J. S., Bachinsky, W. B., Lincoff, A. M., Califf, R. M., Topol, E. J. (2000). Facilitation of early percutaneous coronary intervention after reteplase with or without abciximab in acute myocardial infarction: Results from the SPEED (GUSTO-4 Pilot) trial. J Am Coll Cardiol 36: 1489-1496 [Abstract] [Full Text]  
• Gibler, W. B., Hoekstra, J. W., Weaver, W. D., Krucoff, M. W., Hallstrom, A. P., Jackson, R. E., Sayre, M. R., Christenson, J., Higgins, G. L., Innes, G., Harper, R. J., Young, G. P., Every, N. R., for the SMARTT Investigators, (2000). A randomized trial of the effects of early cardiac serum marker availability on reperfusion therapy in patients with acute myocardial infarction: The serial markers, acute myocardial infarction and rapid treatment trial (SMARTT). J Am Coll Cardiol 36: 1500-1506 [Abstract] [Full Text]  
• Hannan, E. L., Racz, M. J., Arani, D. T., Ryan, T. J., Walford, G., McCallister, B. D. (2000). Short- and long-term mortality for patients undergoing primary angioplasty for acute myocardial infarction. J Am Coll Cardiol 36: 1194-1201 [Abstract] [Full Text]  
• Schomig, A., Kastrati, A., Dirschinger, J., Mehilli, J., Schricke, U., Pache, J., Martinoff, S., Neumann, F.-J., Schwaiger, M., The Stent versus Thrombolysis for Occluded Coronar, (2000). Coronary Stenting plus Platelet Glycoprotein IIb/IIIa Blockade Compared with Tissue Plasminogen Activator in Acute Myocardial Infarction. NEJM 343: 385-391 [Abstract] [Full Text]  
• Berger, A. K., Radford, M. J., Wang, Y., Krumholz, H. M. (2000). Thrombolytic therapy in older patients. J Am Coll Cardiol 36: 366-374 [Abstract] [Full Text]  
• Cannon, C. P., Gibson, C. M., Lambrew, C. T., Shoultz, D. A., Levy, D., French, W. J., Gore, J. M., Weaver, W. D., Rogers, W. J., Tiefenbrunn, A. J. (2000). Relationship of Symptom-Onset-to-Balloon Time and Door-to-Balloon Time With Mortality in Patients Undergoing Angioplasty for Acute Myocardial Infarction. JAMA 283: 2941-2947 [Abstract] [Full Text]  
• Natarajan, M. K., Mehta, S., Yusuf, S. (2000). Management of myocardial infarction: looking beyond efficacy. J Am Coll Cardiol 35: 380-381 [Full Text]  
• Matetzky, S., Novikov, M., Gruberg, L., Freimark, D., Feinberg, M., Elian, D., Novikov, I., Di Segni, E., Agranat, O., Har-Zahav, Y., Rabinowitz, B., Kaplinsky, E., Hod, H. (1999). The significance of persistent ST elevation versus early resolution of ST segment elevation after primary PTCA. J Am Coll Cardiol 34: 1932-1938 [Abstract] [Full Text]  
• Ross, A. M., Coyne, K. S., Reiner, J. S., Greenhouse, S. W., Fink, C., Frey, A., Moreyra, E., Traboulsi, M., Racine, N., Riba, A. L., Thompson, M. A., Rohrbeck, S., Lundergan, C. F., for the PACT Investigators, (1999). A randomized trial comparing primary angioplasty with a strategy of short-acting thrombolysis and immediate planned rescue angioplasty in acute myocardial infarction: the PACT trial. J Am Coll Cardiol 34: 1954-1962 [Abstract] [Full Text]  
• Zijlstra, F., Hoorntje, J. C.A., de Boer, M.-J., Reiffers, S., Miedema, K., Ottervanger, J. P., van 't Hof, A. W.J., Suryapranata, H. (1999). Long-Term Benefit of Primary Angioplasty as Compared with Thrombolytic Therapy for Acute Myocardial Infarction. NEJM 341: 1413-1419 [Abstract] [Full Text]  
• Faxon, D. P., Heger, J. W. (1999). Primary Angioplasty -- Enduring the Test of Time. NEJM 341: 1464-1465 [Full Text]  
• BRENER, S, TOPOL, E J (1999). Logic and logistics: conundrum in reperfusion treatment for acute myocardial infarction. Heart 82: 402-403 [Full Text]  
• Zahn, R, Schiele, R, Seidl, K, Hauptmann, K E, Voigtlander, T, Rupprecht, H-J, Gottwik, M, Glunz, H G, Senges, J (1999). Spectrum of reperfusion strategies and factors influencing the use of primary angioplasty in patients with acute myocardial infarction admitted to hospitals with the facilities to perform primary angioplasty. Heart 82: 420-425 [Abstract] [Full Text]  
• Halvorsen, C. E., Hartmann, A., Jenssen, T., Fauchald, P., Brekke, I. B., Jakobsen, J. A. (1999). Salvage of a renal graft by percutaneous transluminal angioplasty of the occluding transplant artery. Nephrol Dial Transplant 14: 2231-2233 [Full Text]  
• Berger, A. K., Schulman, K. A., Gersh, B. J., Pirzada, S., Breall, J. A., Johnson, A. E., Every, N. R. (1999). Primary Coronary Angioplasty vs Thrombolysis for the Management of Acute Myocardial Infarction in Elderly Patients. JAMA 282: 341-348 [Abstract] [Full Text]  
• Berger, P. B., Ellis, S. G., Holmes, D. R. Jr, Granger, C. B., Criger, D. A., Betriu, A., Topol, E. J., Califf, R. M. (1999). Relationship Between Delay in Performing Direct Coronary Angioplasty and Early Clinical Outcome in Patients With Acute Myocardial Infarction : Results From the Global Use of Strategies to Open Occluded Arteries in Acute Coronary Syndromes (GUSTO-IIb) Trial. Circulation 100: 14-20 [Abstract] [Full Text]  
• Gottlieb, S., Boyko, V., Harpaz, D., Hod, H., Cohen, M., Mandelzweig, L., Khoury, Z., Stern, S., Behar, S., for the Israeli Thrombolytic Survey Group, (1999). Long-term (three-year) prognosis of patients treated with reperfusion or conservatively after acute myocardial infarction. J Am Coll Cardiol 34: 70-82 [Abstract] [Full Text]  
• Every, N. R., Frederick, P. D., Robinson, M., Sugarman, J., Bowlby, L., Barron, H. V. (1999). A comparison of the National Registry of Myocardial Infarction 2 with the Cooperative Cardiovascular Project. J Am Coll Cardiol 33: 1886-1894 [Abstract] [Full Text]  
• Danchin, N., Vaur, L., Genes, N., Etienne, S., Angioi, M., Ferrieres, J., Cambou, J.-P. (1999). Treatment of Acute Myocardial Infarction by Primary Coronary Angioplasty or Intravenous Thrombolysis in the "Real World" : One-Year Results From a Nationwide French Survey. Circulation 99: 2639-2644 [Abstract] [Full Text]  
• Gibson, C. M. (1999). Primary Angioplasty Compared with Thrombolysis: New Issues in the Era of Glycoprotein IIb/IIIa Inhibition and Intracoronary Stenting. ANN INTERN MED 130: 841-847 [Abstract] [Full Text]  
• Scanlon, P. J., Faxon, D. P., Audet, A.-M., Carabello, B., Dehmer, G. J., Eagle, K. A., Legako, R. D., Leon, D. F., Murray, J. A., Nissen, S. E., Pepine, C. J., Watson, R. M., Ritchie, J. L., Gibbons, R. J., Cheitlin, M. D., Eagle, K. A., Gardner, T. J., Garson, A. Jr, Russell, R. O. Jr, Ryan, T. J., Smith, S. C. Jr (1999). ACC/AHA guidelines for coronary angiography: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Coronary Angiography) developed in collaboration with the Society for Cardiac Angiography and Interventions. J Am Coll Cardiol 33: 1756-1824 [Full Text]  
• Gandhi, M. M, Dawkins, K. D (1999). Fortnightly review: Intracoronary stents. BMJ 318: 650-653 [Full Text]  
• Garcia, E., Elizaga, J., Perez-Castellano, N., Serrano, J. A., Soriano, J., Abeytua, M., Botas, J., Rubio, R., Lopez de Sa, E., Lopez-Sendon, J. L., Delcan, J. L. (1999). Primary angioplasty versus systemic thrombolysis in anterior myocardial infarction. J Am Coll Cardiol 33: 605-611 [Abstract] [Full Text]  
• Nunn, C. M., O'Neill, W. W., Rothbaum, D., Stone, G. W., O'Keefe, J., Overlie, P., Donohue, B., Grines, L., Browne, K. F., Vlietstra, R. E., Catlin, T., Grines, C. L., For The Primary Angioplasty in Myocardial Infarcti, (1999). Long-term outcome after primary angioplasty: report from the Primary Angioplasty in Myocardial Infarction (PAMI-I) trial. J Am Coll Cardiol 33: 640-646 [Abstract] [Full Text]  
• Shlipak, M. G., Lyons, W. L., Go, A. S., Chou, T. M., Evans, G. T., Browner, W. S. (1999). Should the Electrocardiogram Be Used to Guide Therapy for Patients With Left Bundle-Branch Block and Suspected Myocardial Infarction?. JAMA 281: 714-719 [Abstract] [Full Text]  
• Waugh, J. M., Kattash, M., Li, J., Yuksel, E., Kuo, M. D., Lussier, M., Weinfeld, A. B., Saxena, R., Rabinovsky, E. D., Thung, S., Woo, S. L. C., Shenaq, S. M. (1999). Gene therapy to promote thromboresistance: Local overexpression of tissue plasminogen activator to prevent arterial thrombosis in an in vivo rabbit model. Proc. Natl. Acad. Sci. USA 96: 1065-1070 [Abstract] [Full Text]  
• Ramunno, L. D., Dodds, T. A., Traven, N. D. (1998). Cooperative Cardiovascular Project (CCP) Quality Improvement in Maine, New Hampshire, and Vermont. Eval Health Prof 21: 442-460 [Abstract]  
• Ribichini, F., Steffenino, G., Dellavalle, A., Ferrero, V., Vado, A., Feola, M., Uslenghi, E. (1998). Comparison of thrombolytic therapy and primary coronary angioplasty with liberal stenting for inferior myocardial infarction with precordial ST-segment depression: Immediate and long-term results of a randomized study. J Am Coll Cardiol 32: 1687-1694 [Abstract] [Full Text]  
• Waldecker, B., Waas, W., Haberbosch, W., Voss, R., Heizmann, H., Tillmanns, H. (1998). Long-term follow-up after direct percutaneous transluminal coronary angioplasty for acute myocardial infarction. J Am Coll Cardiol 32: 1320-1325 [Abstract] [Full Text]  
• Weaver, W. D., Simes, R. J., Betriu, A., Grines, C. L., Zijlstra, F., Garcia, E., Grinfeld, L., Gibbons, R. J., Ribeiro, E. E., DeWood, M. A., Ribichini, F. (1997). Comparison of Primary Coronary Angioplasty and Intravenous Thrombolytic Therapy for Acute Myocardial Infarction: A Quantitative Review. JAMA 278: 2093-2098 [Abstract]  
• Yusuf, S., Pogue, J. (1997). Primary Angioplasty Compared With Thrombolytic Therapy for Acute Myocardial Infarction. JAMA 278: 2110-2111 [Abstract]  
• Stone, G. W., Grines, C. L., O'Neill, W. W., Pasceri, V., Ellis, S. G., Topol, E. J., Betriu, A., Califf, R. M. (1997). Primary Coronary Angioplasty versus Thrombolysis. NEJM 337: 1168-1170 [Full Text]  
• LIM, R., WALTERS, M. I, NORELL, M. S (1997). Transferring patients for primary infarct angioplasty. Heart 78: 325-326 [Full Text]  
• Gore, J. M., Dalen, J. E. (1997). Cardiovascular Disease. JAMA 277: 1845-1846  
• The Global Use of Strategies to Open Occluded Coro, (1997). A Clinical Trial Comparing Primary Coronary Angioplasty with Tissue Plasminogen Activator for Acute Myocardial Infarction. NEJM 336: 1621-1628 [Abstract] [Full Text]  
• Zijlstra, F., Hoorntje, J. C.A., de Boer, M.-J., Magalski, A., O'Keefe, J. H., Leff, B., Lange, R. A., Hillis, L. D., Grines, C. L. (1997). Thrombolysis or Primary Angioplasty for Acute Myocardial Infarction?. NEJM 336: 1101-1103 [Full Text]  
• Lee, J. S., Fath-Ordoubadi, F., Beatt, K. J., Every, N. R., Weaver, W. D. (1997). A Comparison of Thrombolytic Therapy with Primary Coronary Angioplasty for Acute Myocardial Infarction. NEJM 336: 1103-1104 [Full Text]  
• Ramsdale, D. R, Morris, J. L (1997). Angioplasty has been shown to have benefits over thrombolytic treatment. BMJ 314: 515-515 [Full Text]  
• (1996). Primary PTCA versus Thrombolysis. Journal Watch Cardiology 1996: 1-1 [Full Text]  
• (1996). THROMBOLYTIC THERAPY VS. ANGIOPLASTY FOR ACUTE MI. JWatch General 1996: 1-1 [Full Text]  
• Bittl, J. A. (1996). Advances in Coronary Angioplasty. NEJM 335: 1290-1302 [Full Text]  
• Lange, R. A., Hillis, L. D., Grines, C. L., Lange, R. A., Hillis, L. D., Grines, C. L. (1996). Should Thrombolysis or Primary Angioplasty Be the Treatment of Choice for Acute Myocardial Infarction?. NEJM 335: 1311-1312 [Full Text]