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Table 3 Six-and 12-month outcomes of randomized clinical trials comparing an invasive treatment strategy to a delayed invasive or ischemia-guided approach among STEMI patients treated with fibrinolysis.

From: Routine invasive management after fibrinolysis in patients with ST-elevation myocardial infarction: a systematic review of randomized clinical trials

Study

Follow-Up

Outcome

Risk in Invasive Group

(n/N)

Risk in Selective Group

(n/N)

Relative Risk

(95% CI)

p-value

PRAGUE[17]

12 Months

Death/Non-Fatal Reinfarction

18/100

30/99

0.59 (0.36, 0.99)

0.04‡

  

Death

12/100

18/99

0.66 (0.34, 1.30)

0.22‡

  

Non-Fatal Reinfarction

6/100

12/99

0.50 (0.19, 1.27)

0.13‡

SIAM-3[18]

6 Months†

CABG

6/82

6/81

0.99 (0.33, 2.94)‡

0.609

  

TLR

16/82

19/81

0.83 (0.46, 1.50)‡

0.336

  

Ischemic Events

4/82

23/81

0.17 (0.06, 0.47)‡

0.001

  

Reinfarction

2/82

2/81

0.99 (0.14, 6.84)‡

0.685

  

Death

4/82

9/81

0.44 (0.14, 1.37)‡

0.119

  

Death/Reinfarction

6/82

11/81

0.54 (0.21, 1.39)‡

0.146

  

Death/Reinfarction/TLR

20/82

29/81

0.68 (0.42, 1.10)‡

0.078

  

Death/Reinfarction/TLR/Ischemic Events*

21/82

41/81

0.51 (0.33, 0.78)‡

0.001

 

6 Months††

CABG

12/94

19/103

0.69 (0.36, 1.35)‡

0.185

  

TLR

22/94

31/103

0.78 (0.49, 1.24)‡

0.185

  

Ischemic Events

7/94

28/103

0.27 (0.13, 0.60)‡

0.001

  

Reinfarction

3/94

3/103

1.10 (0.23, 5.30)‡

0.614

  

Death

4/94

9/103

0.49 (0.16, 1.53)‡

0.164

  

Death/Reinfarction

7/94

12/103

0.64 (0.27, 1.56)‡

0.225

  

Death/Reinfarction/TLR

26/94

41/103

0.69 (0.46, 1.04)‡

0.049

  

Death/Reinfarction/TLR/Ischemic Events

28/94

55/103

0.56 (0.39, 0.80)‡

0.001

GRACIA-1[19]

12 Months

Death

9/248

16/251

0.55 (0.22, 1.36)

0.16

  

Non-Fatal Reinfarction

9/248

15/251

0.60 (0.27, 1.36)

0.22

  

Death/Non-Fatal Reinfarction

17/248

29/251

0.59 (0.33, 1.05)

0.07

  

Revascularization

9/248

30/251

0.30 (0.15, 0.62)

0.001

  

Readmission due to Ischemia

37/248

62/251

0.60 (0.42, 0.87)

0.006

  

Death/Non-Fatal Reinfarction/Revascularization*

23/248

51/251

0.44 (0.28, 0.70)

0.0008

CAPITAL-AMI[20]

6 Months

Death/Recurrent MI/Recurrent Unstable Ischemia, Stroke*

10/86

20/84

0.48 (0.24, 0.96)

0.04

  

Death

3/86

3/84

0.95 (0.20, 4.59)

1.00

  

Reinfarction

5/86

12/84

0.40 (0.15, 1.08)

0.07

  

Recurrent Unstable Ischemia

7/86

17/84

0.39 (0.17, 0.90)

0.03

  

Stroke

1/86

1/84

0.95 (0.60, 14.99)

1.00

  

Death/Reinfarction/Stroke

8/86

15/84

0.51 (0.23, 1.14)

0.12

Leipzig[23]

6 Months

Death

5/82

6/82

0.83 (0.22, 2.99)

0.68Â¥

  

Death/Reinfarction/Stroke/Major Bleeding

12/82

21/82

0.57 (0.28, 1.13)

0.10Â¥

TRANSFER AMI[27]

6 Months

Death

30/528

23/511

1.27 (0.77, 2.23)

0.39

  

Reinfarction

21/528

33/511

0.60 (0.34, 1.05)

0.07

  

Death/Reinfarction

47/528

54/511

0.83 (0.55, 1.25)

0.36

NORDISTEMI[28]

12 Months

Death/Reinfarction/Stroke/New Ischemia*

28/134

36/132

0.77 (0.50, 1.18)‡

0.22‡

  

Death/Reinfarction/Stroke

8/134

21/132

0.38 (0.17, 0.82)‡

0.008‡

  

Death

3/134

4/132

0.74 (0.17, 3.24)‡

0.72‡

  

Reinfarction

4/134

12/132

0.33 (0.11, 0.99)‡

0.04‡

  

Stroke

3/134

7/132

0.42 (0.11, 1.60)‡

0.22‡

  

Recurrent Ischemia

20/134

20/132

0.99 (0.56, 1.74)‡

0.96‡

  1. Abbreviations: CHF: congestive heart failure; CI: confidence interval; MI: myocardial infarction; TLR: target lesion revascularization. * Denotes primary endpoint of the trial. † Data are based on the 163 patients who met the secondary inclusion criteria rather than the 197 who were randomized. †† Data are based on the 197 patients who were randomized. ‡ Calculated using data presented in the original manuscript. ¥ Denotes p-value from log-rank test.