Circulation 2001;104: Circulation 2001;104:

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Circulation 2001;104:2632-2634.

Median Time (hrs) Between Symptom Onset and Treatment Time from Symptom Onset to Study Treatment in Large Scale Thrombolytic Trials 2.8 2.7 2.9 2.8 2.7 2.7 Median Time (hrs) Between Symptom Onset and Treatment GUSTO I 90-93 GUSTO III 95-97 InTIME II 97-99 ASSENT II 97-98 GUSTO V 99-01 ASSENT 3 00-01 Gibson CM, Circulation 2001;104:2632-2634

Benefits of PCI vs Lysis: The Importance of Timing Kent DM et al Eff Clin Pract 4: 214, 2001

Primary PCI for STEMI Time to Reperfusion and 30 Day Mortality CADILLAC Zwolle N= 2002 N= 1791 1994-2001 9.6 P=0.04 (< 3h v > 3 h) P < 0.001 % Mortality 5.6 2.3 2.2 3.1 2.5 0.9 Cox ACC ‘03 Abst 827-1 DeLuca ACC ‘03 Abst 827-3 Time to Reperfusion (h)

NRMI-2: Primary PCI Door-to-Balloon time vs. Mortality Lecture Notes Shown here are the raw absolute mortality rates for a variety of door to balloon times. References 1. Cannon CP et al, JAMA 2000 Door-to-Balloon Time (minutes)

Door to Balloon Times Among Patients Transferred in NRMI 4 Data: 50th: 8 Min. 25th: 4 Min. 75th: 16 Min. Data to Cath Lab Arrival: 50th: 137 Min. 25th: 87 Min. 75th: 220 Min. Cath Lab to Balloon: 50th: 39 Min. 25th: 29 Min 75th: 53 Min. 8 137 39 Lecture Notes Shown here is current data from the NRMI. Currently in the US, the median door to balloon time is 198 minutes. This is much longer than the 114 minutes in DANAMI 2. References NRMI 4 data on file. Total Door to Balloon Time: 198 minutes (25th: 137; 75th: 281) Percent of Patients with Door to Balloon Time < 90 Min.: 4.8% Sample Size: 1,292; Time Period: October 2000 – September 2001 Gibson 2003 NRMI 4 Transfer-In Annual Data Report 2002

DANAMI vs US AMI: Are We As Quick In The US? 198 Min. 110 Min. Median Time (Min.) 90 Min. DANAMI On Site 1o PCI DANAMI Transfer 1o PCI US AMI Transfer 1o PCI