Primary angioplasty for the treatment of acute ST-segment elevated myocardial infarction: an evidence-based analysis

Record ID 32004000836
English
Authors' objectives:

This study aims to review the the clinical benefits and policy implications of funding primary angioplasty to treat acute myocardial infarction (MI) for patients who show evidence of ST-segment-elevation on electrocardiogram.

Authors' recommendations: Conclusions and recommendations about providing primary angioplasty to treat acute STEMI in Ontario are predicated on the findings from the literature review, meta-analysis, and economic analysis. Therefore, based on the evidence, it would appear that primary angioplasty and thrombolysis within 120 minutes of the onset of chest pain for acute STEMI can be regarded as equivalent technologies. Ideally, angioplasty should be offered to patients who have undergone thrombolysis but who have persistent STEMI after 90 minutes (i.e., rescue angioplasty). The use of primary angioplasty with thrombolysis (i.e., facilitated angioplasty) is regarded as experimental and is not recommended as standard care at this time. Efforts should be made to enable patients to access primary angioplasty or thrombolysis expeditiously, but the province-wide reorganization of emergency medical services is considered impractical; therefore, alternative strategies should be considered to achieve these objectives.
Authors' methods: Systematic review
Details
Project Status: Completed
Year Published: 2004
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Canada
MeSH Terms
  • Angioplasty
  • Costs and Cost Analysis
  • Myocardial Infarction
Contact
Organisation Name: Medical Advisory Secretariat
Contact Address: Medical Advisory Secretariat, 20 Dundas Street West, 10th Floor, Toronto, ON M5G 2N6 CANADA. Tel: 416-314-1092l; Fax: 416-325-2364;
Contact Name: MASinfo.moh@ontario.ca
Contact Email: MASinfo.moh@ontario.ca
Copyright: Medical Advisory Secretariat, Ontario Ministry of Health and Long-Term Care
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.