Acute Myocardial Infarction Clinical Trial
Official title:
Efficacy and Safety of Prehospital Administration of Bivalirudin in STEMI Patients Redirected for Primary PCI Based on Tele-Transmitted 12-Lead ECGs
The purpose of this study is to describe the efficacy and safety of prehospital administration of bivalirudin, as a substitute for heparin, in patients with acute myocardial infarction redirected for primary angioplasty bypassing local hospitals, immediately after the diagnosis is confirmed via tele-transmission of a 12-lead electrocardiogram.
Primary angioplasty (pPCI) is the therapy of choice in patients with ST elevation acute
myocardial infarction (STEMI) in Denmark. However, time is lost transferring patients from a
local hospital to an invasive treatment centre. Time can be saved by redirecting STEMI
patients to pPCI based on wireless prehospital 12-lead electrocardiogram (ECG) transmission
directly to a cardiologist's handheld device. To prevent complications during the
transportation of STEMI patients to the invasive hospital, patients are treated with oxygen,
aspirin, clopidogrel, heparin, and nitro-glycerine in the ambulance. However, heparin use is
cumbersome for the ambulance personnel since it must be kept at 5 degrees Celsius. An
alternative to heparin may be bivalirudin, since it can be kept at room temperature and thus
is easily administered in the prehospital setting.
Comparison: Heparin versus bivalirudin treatment. Efficacy is determined by thrombolysis in
myocardial infarction (TIMI) flow in the first and final coronary angiogram. Safety is
determined by the rate of bleeding complication.
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Observational Model: Case Control
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