Online Appendix for the following January 30 JACC article
TITLE: Rescue Angioplasty or Repeat Fibrinolysis after Failed Fibrinolytic Therapy for STSegment Myocardial Infarction: A Meta-Analysis of Randomized Trials
AUTHORS:
Harindra C. Wijeysundera, MD, Division of Cardiology, Schulich Heart Centre and Department
of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada, Ram
Vijayaraghavan, MD, Division of Cardiology, Schulich Heart Centre and Department of
Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada,
Brahmajee K. Nallamothu, MD, MPH, Health Services and Research Development Center of
Excellence, Ann Arbor VA Medical Center, Ann Arbor, Michigan, JoAnne M. Foody, MD,
Section of Cardiovascular Medicine, Department of Medicine, Yale University School of
Medicine, New Haven, Connecticut, West Haven Veterans Administration Medical Center, West
Haven, Connecticut, Harlan M. Krumholz, MD, SM, Section of Cardiovascular Medicine,
Department of Medicine, Yale University School of Medicine, New Haven, Connecticut, Section
of Health Policy and Administration, Department of Epidemiology and Public Health, Robert
Wood Johnson Clinical Scholars Program, Yale University School of Medicine, and the Center
for Outcomes Research and Evaluation, Yale-New Haven Health, New Haven, Connecticut,
Christopher O. Phillips, MD, MPH, The Cleveland Clinic Foundation, Cleveland, Ohio, Amir
Kashani, MD, MS, Section of Cardiovascular Medicine, Department of Medicine, Yale
University School of Medicine, New Haven, Connecticut, John J. You, MD, Department of
General Internal Medicine, University Health Network, Ontario, Canada, Department of
Medicine, Sunnybrook Health Sciences Centre, Ontario, Canada, Jack V. Tu, MD, PhD,
Department of Medicine, Sunnybrook Health Sciences Centre, Ontario, Canada, Institute for
Clinical Evaluative Sciences, Toronto, Ontario, Canada, Dennis T. Ko, MD, MSc, Division of
Cardiology, Schulich Heart Centre and Department of Medicine, Sunnybrook Health Sciences
Centre, University of Toronto, Ontario, Canada, Institute for Clinical Evaluative Sciences,
Toronto, Ontario, Canada
APPENDIX
Efficacy and Safety End Point Definitions
Rescue PCI
Trial
Name
REACT
MERLIN
RESCUE II
Reinfarction
Heart
Failure
Major
Bleeding
Minor
Bleeding
Stroke
Chest pain lasting
more than 30 minutes
and accompanied by
new ECG changes,
enzyme rise or both
Heart failure with
pulmonary edema
during index
hospitalization or
NYHA functional
class III/IV heart
failure requiring readmission
Requirement for
diuretic treatment
in the presence of
typical chest X-ray
characteristics or
auscultatory
crackles
Data for end point
not reported
Decrease in
hemoglobin of at
least 5 g/dl, severe
bleeding event or
both
Observed bleeding
during index
admission
New
neurological
deficit lasting
>24 h
Data for end point
not reported
Transfusion
required with fall
in hemoglobin >2
g/dl
New
neurological
deficit lasting
>24 h
Data for end point
not reported
Data for end point
not reported
Data for end
point not
reported
Data for end point
not reported
Data for end point
not reported
Data for end point
not reported
Data for end point
not reported
Data for end point
not reported
Observed bleeding
Data for end
point not
reported
Data for end
point not
reported
Data for end
point not
reported
Chest pain lasting
more than 30 minutes
associated with
typical ECG
re-elevation
Data for end point
not reported
RESCUE
Data for end point
not reported
TAMI
Not defined
NYHA functional
class III/IV heart
failure
Not defined
Belenkie et al.
Data for end point
not reported
Data for end point
not reported
Trial
Name
REACT
Reinfarction
Chest pain lasting
more than 30 min and
accompanied by new
ECG changes,
enzyme rise or both
Sarullo et al.
Not defined
Mounsey et al.
Data for end point
not reported
Repeat Fibrinolysis
Heart
Major
Failure
Bleeding
Minor
Bleeding
Stroke
Heart failure with
pulmonary edema
during index
hospitalization or
NYHA functional
class III/IV heart
failure requiring readmission
Data for end point
not reported
Decrease in
hemoglobin of at
least 5 g/dl, severe
bleeding event, or
both
Observed bleeding
during index
admission
New
neurological
deficit lasting
>24 h
Not defined
Not defined
Data for end
point not
reported
Data for end point
not reported
Data for end point
not reported
Transfusion
required
Data for end
point not
reported
ECG = electrocardiogram; MERLIN = Middlesbrough Early Revascularization to Limit Infarction; NYHA =
New York Heart Association; PCI = percutaneous coronary intervention; REACT = Rescue Angioplasty
versus Conservative Treatment or Repeat Thrombolysis; RESCUE = Randomized Comparison of Rescue
Angioplasty With Conservative Management of Patients With Early Failure of Thrombolysis for Acute
Anterior Myocardial Infarction trial; TAMI = Thrombolysis and Angioplasty in Myocardial Infarction study.