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The NORwegian study on DIstrict treatment of ST-elevation myocardial infarction (NORDISTEMI)

Ellen Bøhmer1, Harald Arnesen, Michael Abdelnoor

  • 1Department of Cardiology, Ullevål University Hospital, Oslo, Norway.

Scandinavian Cardiovascular Journal : SCJ
|March 17, 2007
PubMed

Insights

This study compares immediate transfer for intervention versus conservative management after thrombolysis for ST-elevation myocardial infarction (STEMI) in rural areas. It aims to determine the optimal treatment strategy for these patients.

Area of Science:

  • Cardiology
  • Emergency Medicine
  • Clinical Trials

Background:

  • Thrombolysis is crucial for ST-elevation myocardial infarction (STEMI) patients in rural settings with delayed percutaneous coronary intervention (PCI).
  • Optimal post-thrombolysis management strategies for STEMI patients with long transfer delays remain under investigation.

Purpose of the Study:

  • To compare immediate transfer for coronary angiography and intervention versus conservative management following thrombolysis in STEMI patients.
  • To evaluate the one-year combined incidence of death, reinfarction, stroke, or new myocardial ischemia.

Main Methods:

  • The NORwegian study on DIstrict treatment of STEMI (NORDISTEMI) is an open, prospective, randomized controlled trial.
  • 266 STEMI patients with <6 hours symptom duration and >90 minutes delay to PCI will receive thrombolysis and be randomized.
  • Primary endpoint: one-year combined incidence of death, reinfarction, stroke, or new myocardial ischemia.

Main Results:

  • As of April 2006, 109 patients were randomized.
  • Pre-hospital thrombolysis was administered to 52% of patients.
  • Median transport distance to catheterization laboratory was 155 km.

Conclusions:

  • Study results are anticipated in 2008.
  • The findings will inform treatment guidelines for STEMI patients in remote areas.
  • This trial addresses a critical gap in managing STEMI patients with limited access to timely PCI.
Abstract

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