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Systematic review and meta-analysis

This trial is included in the following systematic reviews and meta-analyses:

acute myocardial infarction - myocardial revascularization - all type of patients

acute myocardial infarction - PCI - all type of patients


Related trials

TRIANA, 2009 - primary ballon angioplasty vs tenecteplase

DEBATER (SES vs BMS), 2009 - sirolimus eluting stent vs bare-metal stent

NORDISTEMI, 2009 - thrombolysis + angioplasty vs immediate thrombolysis

Juwana, 2009 - sirolimus eluting stent vs paclitaxel eluting stent

ZEST AMI (vs PES), 2009 - zotarolimus eluting stent vs paclitaxel eluting stent

PASEO, 2009 - drug-eluting stents vs bare-metal stent

ZEST AMI (vs SES), 2009 - zotarolimus eluting stent vs sirolimus eluting stent

CARESS, 2008 - thrombolysis + angioplasty vs immediate thrombolysis

HORIZONS-AMI Stent, 2008 - paclitaxel eluting stent vs bare-metal stent

MISSION, 2008 - sirolimus eluting stent vs bare-metal stent

DEDICATION, 2008 - drug-eluting stents vs bare-metal stent

D�az de la Llera, 2007 - sirolimus eluting stent vs bare-metal stent

SESAMI, 2007 - sirolimus eluting stent vs bare-metal stent

PROSIT, 2006 - sirolimus eluting stent vs paclitaxel eluting stent

HAAMU-STENT, 2006 - paclitaxel eluting stent vs bare-metal stent

PASSION, 2006 - paclitaxel eluting stent vs bare-metal stent

WEST, 2006 - systematic PCI (+stent) vs no systematic PCI

TYPHOON, 2006 - sirolimus eluting stent vs bare-metal stent

ZWOLLE 6, 2005 - primary stenting vs balloon angioplasty

CAPITAL AMI, 2005 - systematic PCI (+stent) vs no systematic PCI

senior PAMI, 2005 - primary PCI vs Thrombolysis

CAPITAL AMI, 2005 - thrombolysis + angioplasty vs immediate thrombolysis

Di Lorenzo et al., 2005 - sirolimus eluting stent vs paclitaxel eluting stent

GRACIA-1, 2004 - systematic PCI (+stent) vs no systematic PCI

MERLIN (Sutton), 2004 - immediate systematic ballon angioplastyte vs no immediate angioplasty



See also:

  • All acute myocardial infarction clinical trials
  • All clinical trials of PCI
  • All clinical trials of systematic PCI (+stent)
    		•  

    WEST study, 2006

    Facebook    pdf : systematic PCI (+stent) - myocardial revascularization for acute myocardial infarction

    Treatments

    Studied treatment TNK and mandatory invasive study <= 24 h, including rescue PCI for reperfusion failure
    Control treatment tenecteplase (TNK) and usual care
    Treatments description
    stent (%) 97% 
    time from thrombolysisi to PCI in invasive arm 295 min 

    Patients

    Patients STEMI patients (> 4 mm ST-elevation/deviation) within 6 h of symptom onse
    Baseline characteristics
    Age (year) 58 y 
    female (%) 20% 

    Method and design

    Randomized effectives 104 / 100 (studied vs. control)
    Design Parallel groups
    Follow-up duration 30 days
    Geographic area Canada
    Primary endpoint death, re-MI, refractory ischaemia, HF, shock, major ventricular arrhythmia


    Results

    Endpoint Studied treat.
    n/N     Control treat.
    n/N     Graph RR [95% CI]

    In-hospital death

    1 / 104
         4 / 100
         classic 0,24 [0,03;2,11]

    reinfarction

    6 / 104
         9 / 100
         0,64 [0,24;1,74]

    Major bleeding

    2 / 104
         1 / 100
         classic 1,92 [0,18;20,88]

    stroke (fatal and non fatal)

    1 / 104
         0 / 100
         classic 4,81 [0,07;349,18]     0 2 1.0

    Relative risks
    Endpoint Events (%) Relative Risk 95% CI Endpoint definition
    in the trial    		 Ref
    Studied treat. Control treat.
    In-hospital death 1 / 104 (1,0%) 4 / 100 (4,0%) 0,24 [0,03;2,11]   9448 
    reinfarction 6 / 104 (5,8%) 9 / 100 (9,0%) 0,64 [0,24;1,74]   9448 
    Major bleeding 2 / 104 (1,9%) 1 / 100 (1,0%) 1,92 [0,18;20,88]   9448 
    stroke (fatal and non fatal) 1 / 104 (1,0%) 0 / 100 (0,5%) 1,92 [0,07;56,69]   9448 
    The primary endpoint (if exists) appears in blod characters
    Reference(s) used for data extraction:
  • 9448: Wijeysundera HC, You JJ, Nallamothu BK, Krumholz HM, Cantor WJ, Ko DTAn early invasive strategy versus ischemia-guided management after fibrinolytic therapy for ST-segment elevation myocardial infarction: a meta-analysis of contemporary randomized controlled trials.Am Heart J 2008;156:564-572, 572.e1-2

    • Endpoint studied treat. control treat. mean diff

    Absolute risk reduction
    Endpoint Events rate Absolute risk
    reduction (ARR)
    Studied treat. Control treat.
    In-hospital death 9,62‰ 4,00% -30,4‰
    reinfarction 5,77% 9,00% -32,3‰
    Major bleeding 1,92% 1,00% 9,2‰

    Meta-analysis of all similar trials:

    myocardial revascularization in acute myocardial infarction for all type of patients

    PCI in acute myocardial infarction for all type of patients



    Reference(s)

    Trials register # NA
    • Armstrong PW. A comparison of pharmacologic therapy with/without timely coronary intervention vs. primary percutaneous intervention early after ST-elevation myocardial infarction: the WEST (Which Early ST-elevation myocardial infarction Therapy) study.. Eur Heart J 2006;27:1530-8
      Pubmed | Hubmed | Fulltext

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