Randomized Controlled Trial

. 2014 Sep 30;130(14):1139-45.

doi: 10.1161/CIRCULATIONAHA.114.009570. Epub 2014 Aug 26.

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

Collaborators, Affiliations

Collaborators

STREAM investigators:
F Van de Werf, P Armstrong, A Gershlick, P Goldstein, R Wilcox, F Van de Werf, P Sinnaeve, P Meert, P Armstrong, R Welsh, A Gershlick, R Wilcox, J Adgey, J Kendall, T Quinn, P Goldstein, G Steg, Y Lambert, K Huber, W Schreiber, L Piegas, A Carvalho, R D Lopes, U Zeymer, H Arntz, J Nanas, C Fresco, A Pesenti, L Aaberge, S Halvorsen, S Grajek, V Sulimov, M Ostojic, F Rosell, K Fox, G Montalescot, C Pollack, J Tijssen, D Weaver, R Brower, P Armstrong, Y Fu, P Jagasia, A Awad, T Temple, R Welsh, N Dianati Maleki, C Price, G Wilms, V Thijs, E Lesaffre, K Bogaerts, A Belmans, G Kalema, E Bluhmki, K Vandenberghe, C Luys, K Broos, A Regelin, T Danays, E Bluhmki, G Goetz, R Delbé, U Fehse, K Bogaerts, T Temple, L Merlini, M Mazzoleni, M Marangione, L Merlini, M Mazzoleni, M Marangione, A Kaff, R Malzer, D Sebald, D Glogar, M Gyöngyösi, F Weidinger, H Weber, G Gaul, F Chmelizek, S Seidl, M Pichler, I Pretsch, M Vergion, M Herssens, C Van Haesendonck, J F K Saraiva, A L F Sparenberg, J A Souza, J B M Moraes, F M Sant'anna, E Tarkieltaub, J R Hansen, E M Oliveira, O Leonhard, W Cantor, M Senaratne, E Aptecar, P Asseman, L Belle, O Belliard, J Berland, A Berthier, C Besnard, A Bonneau, E Bonnefoy, M Brami, G Canu, G Capellier, S Cattan, D Champagnac, P Chapon, B Cheval, J Claudel, P Cohen Tenoudji, P Coste, V Debierre, R Domergue, K Echahed, C El Khoury, E Ferrari, P Garrot, P Henry, B Jardel, R Jilwan, V Julie, R Ketelers, F Lapostolle, J Le Tarnec, B Livarek, Y Mann, X Marchand, F Pajot, T Perret, P Petit, V Probst, A Ricard Hibon, C Robin, A Salama, E Salengro, D Savary, F Schiele, L Soulat, X Tabone, P Taboulet, M Thicoïpe, J Torres, C Tron, G Vanzetto, L Villain-Coquet, S Piper, H C Mochmann, L Nibbe, U Schniedermeier, H Heuer, F Marx, W Schöls, W Lepper, R Grahl, G Muth, G Lappas, I Mantas, E Skoumbourdis, C Dilanas, I Kaprinis, I Vogiatzis, I Zarifis, G Spyromitros, S Konstantinides, D Symeonides, G P Rossi, F Bermano, S Ferlito, P Paolini, L Valagussa, F Della Rovere, F Miccoli, M Chiti, W Vergoni, M Comeglio, G Percoco, M Valgimigli, K Berget, O Skjetne, H Schartum-Hansen, K Andersen, O J Rolstad, O N Aguirre Zurita, R P Castillo León, A C Villar, A Glowka, P Kulus, S Kalinina, A Bushuev, O Barbarash, N Tarasov, I Fomin, E Makarov, V Markov, A Danilenko, E Volkova, A Frolenkov, N Burova, A Yakovlev, L Elchinskaya, S Boldueva, G Klein, I Kolosova, E Ovcharenko, R Fairushin, S Andjelic, V Vukcevic, A Neskovic, M Krotin, T Rajkovic, M Pavlovic, J Perunicic, S Kovacevic, V Petrovic, V Mitov, A Ruiz, A García-Alcántara, M Martínez, J Díaz, M A Paz, F L Manzano, C Martín, C Macaya, E Corral, J J Fernández, F Martín, R García, N Siriwardena, O Rawstorne, A Baumbach, G Manoharan, I Menown, S McHechan, D Morgan

Affiliations

¹ From the Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium (P.R.S., K.V., F.V.d.W.); The Canadian Virtual Coordinating Centre for Global Collaborative Cardiovascular Research (Canadian VIGOUR Centre), University of Alberta, Edmonton, Canada (P.W.A); NIHR, Leicester Cardiovascular Biomedical Research Unit, University Hospitals of Leicester Trust, Leicester, United Kingdom (A.H.G.); Emergency Department and SAMU, Lille University Hospital, Lille, France (P.G.); the Department of Cardiovascular Medicine, University of Nottingham, Nottingham, United Kingdom (R.W.); Centre Hospitalier de Versailles, SAMU 78 and Mobile Intensive Care Unit, Versailles, France (Y.L.); Boehringer Ingelheim, Reims, France (T.D.); Centre Hospitalier Châteauroux, SAMU/SMUR/Urgences, Châteauroux, France (L.S.); the Department of Cardiology, Oslo University Hospital Ulleval, Oslo, Norway (S.H.); Empresa Pública de Emergencias Sanitarias, Almería, Spain (F.R.O.); Clinical Trials Unit, University Medical Center Freiburg, Freiburg, Germany (A.R.); Boehringer Ingelheim, Biberach, Germany (E.B.); and the Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-BioStat), KU Leuven, Leuven and University Hasselt, Hasselt, Belgium (K.B.).
² From the Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium (P.R.S., K.V., F.V.d.W.); The Canadian Virtual Coordinating Centre for Global Collaborative Cardiovascular Research (Canadian VIGOUR Centre), University of Alberta, Edmonton, Canada (P.W.A); NIHR, Leicester Cardiovascular Biomedical Research Unit, University Hospitals of Leicester Trust, Leicester, United Kingdom (A.H.G.); Emergency Department and SAMU, Lille University Hospital, Lille, France (P.G.); the Department of Cardiovascular Medicine, University of Nottingham, Nottingham, United Kingdom (R.W.); Centre Hospitalier de Versailles, SAMU 78 and Mobile Intensive Care Unit, Versailles, France (Y.L.); Boehringer Ingelheim, Reims, France (T.D.); Centre Hospitalier Châteauroux, SAMU/SMUR/Urgences, Châteauroux, France (L.S.); the Department of Cardiology, Oslo University Hospital Ulleval, Oslo, Norway (S.H.); Empresa Pública de Emergencias Sanitarias, Almería, Spain (F.R.O.); Clinical Trials Unit, University Medical Center Freiburg, Freiburg, Germany (A.R.); Boehringer Ingelheim, Biberach, Germany (E.B.); and the Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-BioStat), KU Leuven, Leuven and University Hasselt, Hasselt, Belgium (K.B.). frans.vandewerf@med.kuleuven.be.

PMID: 25161043
DOI: 10.1161/CIRCULATIONAHA.114.009570

Randomized Controlled Trial

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

Peter R Sinnaeve et al. Circulation. 2014.

. 2014 Sep 30;130(14):1139-45.

doi: 10.1161/CIRCULATIONAHA.114.009570. Epub 2014 Aug 26.

Authors

Collaborators

STREAM investigators:
F Van de Werf, P Armstrong, A Gershlick, P Goldstein, R Wilcox, F Van de Werf, P Sinnaeve, P Meert, P Armstrong, R Welsh, A Gershlick, R Wilcox, J Adgey, J Kendall, T Quinn, P Goldstein, G Steg, Y Lambert, K Huber, W Schreiber, L Piegas, A Carvalho, R D Lopes, U Zeymer, H Arntz, J Nanas, C Fresco, A Pesenti, L Aaberge, S Halvorsen, S Grajek, V Sulimov, M Ostojic, F Rosell, K Fox, G Montalescot, C Pollack, J Tijssen, D Weaver, R Brower, P Armstrong, Y Fu, P Jagasia, A Awad, T Temple, R Welsh, N Dianati Maleki, C Price, G Wilms, V Thijs, E Lesaffre, K Bogaerts, A Belmans, G Kalema, E Bluhmki, K Vandenberghe, C Luys, K Broos, A Regelin, T Danays, E Bluhmki, G Goetz, R Delbé, U Fehse, K Bogaerts, T Temple, L Merlini, M Mazzoleni, M Marangione, L Merlini, M Mazzoleni, M Marangione, A Kaff, R Malzer, D Sebald, D Glogar, M Gyöngyösi, F Weidinger, H Weber, G Gaul, F Chmelizek, S Seidl, M Pichler, I Pretsch, M Vergion, M Herssens, C Van Haesendonck, J F K Saraiva, A L F Sparenberg, J A Souza, J B M Moraes, F M Sant'anna, E Tarkieltaub, J R Hansen, E M Oliveira, O Leonhard, W Cantor, M Senaratne, E Aptecar, P Asseman, L Belle, O Belliard, J Berland, A Berthier, C Besnard, A Bonneau, E Bonnefoy, M Brami, G Canu, G Capellier, S Cattan, D Champagnac, P Chapon, B Cheval, J Claudel, P Cohen Tenoudji, P Coste, V Debierre, R Domergue, K Echahed, C El Khoury, E Ferrari, P Garrot, P Henry, B Jardel, R Jilwan, V Julie, R Ketelers, F Lapostolle, J Le Tarnec, B Livarek, Y Mann, X Marchand, F Pajot, T Perret, P Petit, V Probst, A Ricard Hibon, C Robin, A Salama, E Salengro, D Savary, F Schiele, L Soulat, X Tabone, P Taboulet, M Thicoïpe, J Torres, C Tron, G Vanzetto, L Villain-Coquet, S Piper, H C Mochmann, L Nibbe, U Schniedermeier, H Heuer, F Marx, W Schöls, W Lepper, R Grahl, G Muth, G Lappas, I Mantas, E Skoumbourdis, C Dilanas, I Kaprinis, I Vogiatzis, I Zarifis, G Spyromitros, S Konstantinides, D Symeonides, G P Rossi, F Bermano, S Ferlito, P Paolini, L Valagussa, F Della Rovere, F Miccoli, M Chiti, W Vergoni, M Comeglio, G Percoco, M Valgimigli, K Berget, O Skjetne, H Schartum-Hansen, K Andersen, O J Rolstad, O N Aguirre Zurita, R P Castillo León, A C Villar, A Glowka, P Kulus, S Kalinina, A Bushuev, O Barbarash, N Tarasov, I Fomin, E Makarov, V Markov, A Danilenko, E Volkova, A Frolenkov, N Burova, A Yakovlev, L Elchinskaya, S Boldueva, G Klein, I Kolosova, E Ovcharenko, R Fairushin, S Andjelic, V Vukcevic, A Neskovic, M Krotin, T Rajkovic, M Pavlovic, J Perunicic, S Kovacevic, V Petrovic, V Mitov, A Ruiz, A García-Alcántara, M Martínez, J Díaz, M A Paz, F L Manzano, C Martín, C Macaya, E Corral, J J Fernández, F Martín, R García, N Siriwardena, O Rawstorne, A Baumbach, G Manoharan, I Menown, S McHechan, D Morgan

Affiliations

¹ From the Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium (P.R.S., K.V., F.V.d.W.); The Canadian Virtual Coordinating Centre for Global Collaborative Cardiovascular Research (Canadian VIGOUR Centre), University of Alberta, Edmonton, Canada (P.W.A); NIHR, Leicester Cardiovascular Biomedical Research Unit, University Hospitals of Leicester Trust, Leicester, United Kingdom (A.H.G.); Emergency Department and SAMU, Lille University Hospital, Lille, France (P.G.); the Department of Cardiovascular Medicine, University of Nottingham, Nottingham, United Kingdom (R.W.); Centre Hospitalier de Versailles, SAMU 78 and Mobile Intensive Care Unit, Versailles, France (Y.L.); Boehringer Ingelheim, Reims, France (T.D.); Centre Hospitalier Châteauroux, SAMU/SMUR/Urgences, Châteauroux, France (L.S.); the Department of Cardiology, Oslo University Hospital Ulleval, Oslo, Norway (S.H.); Empresa Pública de Emergencias Sanitarias, Almería, Spain (F.R.O.); Clinical Trials Unit, University Medical Center Freiburg, Freiburg, Germany (A.R.); Boehringer Ingelheim, Biberach, Germany (E.B.); and the Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-BioStat), KU Leuven, Leuven and University Hasselt, Hasselt, Belgium (K.B.).
² From the Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium (P.R.S., K.V., F.V.d.W.); The Canadian Virtual Coordinating Centre for Global Collaborative Cardiovascular Research (Canadian VIGOUR Centre), University of Alberta, Edmonton, Canada (P.W.A); NIHR, Leicester Cardiovascular Biomedical Research Unit, University Hospitals of Leicester Trust, Leicester, United Kingdom (A.H.G.); Emergency Department and SAMU, Lille University Hospital, Lille, France (P.G.); the Department of Cardiovascular Medicine, University of Nottingham, Nottingham, United Kingdom (R.W.); Centre Hospitalier de Versailles, SAMU 78 and Mobile Intensive Care Unit, Versailles, France (Y.L.); Boehringer Ingelheim, Reims, France (T.D.); Centre Hospitalier Châteauroux, SAMU/SMUR/Urgences, Châteauroux, France (L.S.); the Department of Cardiology, Oslo University Hospital Ulleval, Oslo, Norway (S.H.); Empresa Pública de Emergencias Sanitarias, Almería, Spain (F.R.O.); Clinical Trials Unit, University Medical Center Freiburg, Freiburg, Germany (A.R.); Boehringer Ingelheim, Biberach, Germany (E.B.); and the Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-BioStat), KU Leuven, Leuven and University Hasselt, Hasselt, Belgium (K.B.). frans.vandewerf@med.kuleuven.be.

PMID: 25161043
DOI: 10.1161/CIRCULATIONAHA.114.009570

Abstract

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.

Keywords: anticoagulants; catheterization; myocardial infarction; thrombolysis, therapeutic.

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Comment in

Evolution from fibrinolytic therapy to a fibrinolytic strategy for patients with ST-segment-elevation myocardial infarction.
Bates ER. Bates ER. Circulation. 2014 Sep 30;130(14):1133-5. doi: 10.1161/CIRCULATIONAHA.114.012539. Epub 2014 Aug 26. Circulation. 2014. PMID: 25161046 No abstract available.

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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

Collaborators

Affiliations

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

Authors

Collaborators

Affiliations

Abstract

Comment in

Publication types

MeSH terms

Substances

Associated data

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical

Research Materials

Miscellaneous