{"id":"8277dd4e0148","type":"article","url":"https://hartvaat.nl/2020/02/14/danami-2-16-jaarsfollow-up-primaire-pci-versus-fibrinolyse/","title":"DANAMI-2 16-jaarsfollow-up: primaire PCI versus fibrinolyse","title_en":"16-year follow-up of the Danish Acute Myocardial Infarction 2 (DANAMI-2) trial: primary percutaneous coronary intervention vs. fibrinolysis in ST-segment elevation myocardial infarction.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":[],"journal":"European heart journal","doi":"10.1093/eurheartj/ehz595","source_url":"https://doi.org/10.1093/eurheartj/ehz595","authors":["Pernille G Thrane","Steen D Kristensen","Kevin K W Olesen","Leif S Mortensen","Hans Erik Bøtker","Leif Thuesen","Henrik S Hansen","Ulrik Abildgaard","Thomas Engstrøm","Henning R Andersen","Michael Maeng"],"significance":7,"published":"2020-02-14","source_date":"2020-02-14","image":"","kennis":["https://hartvaat.nl/kennis/coronairlijden/stemi/","https://hartvaat.nl/kennis/kleplijden/mitralisregurgitatie/"],"congress":"","summary_en":"The 16-year DANAMI-2 follow-up showed that the survival advantage of primary PCI over fibrinolysis for STEMI, including interhospital transfer, persists over very long-term follow-up, providing among the longest comparative data for reperfusion strategies.","created":"2026-07-03T10:28:25Z","updated":"2026-07-03T13:27:36Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"16-jaarsfollow-up van de DANAMI-2-trial die primaire PCI vergeleek met fibrinolyse bij STEMI. Zeer langetermijndata.","abstract_original":"AIMS: The DANish Acute Myocardial Infarction 2 (DANAMI-2) trial found that interhospital transport to primary percutaneous coronary intervention (pPCI) was superior to fibrinolysis at the local hospital in patients with ST-segment elevation myocardial infarction (STEMI) at 30 days. The present study investigates the 16-year cardiovascular outcomes. METHODS AND RESULTS: We randomized 1572 STEMI patients to pPCI or fibrinolysis at 24 referral hospitals and 5 invasive centres in Denmark. Patients randomized to pPCI at referral hospitals were immediately transported to the nearest invasive centre. The main endpoint of the current study was a composite of death or rehospitalization for myocardial infarction (MI). Outcome information beyond 3 years was obtained through Danish health registries. After 16 years, pPCI-treated patients had a sustained lower rate of composite endpoint compared to patients treated with fibrinolysis in the overall cohort [58.7% vs. 62.3%; hazard ratio (HR) 0.86, 95% confidence interval (CI) 0.76-0.98], and among patients transported for pPCI (58.7% vs. 64.1%; HR 0.82, 95% CI 0.71-0.96). No difference in all-cause mortality was found, but cardiac mortality was reduced by an absolute of 4.4% in favour of pPCI (18.3% vs. 22.7%; HR 0.78, 95% CI 0.63-0.98). pPCI postponed a main event with 12.3 months in average compared to fibrinolysis (95% CI 5.0-19.5). CONCLUSION: The benefit of pPCI over fibrinolysis was maintained at 16-year follow-up. pPCI reduced the composite endpoint of death or rehospitalization for MI, reduced cardiac mortality, and delayed average time to a main event by approximately 1 year."}