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To The Editor:Nielsen et al1 report in Circulation the 7.8 years follow-up of the DANAMI-2 trial, showing that the benefit achieved with primary percutaneous coronary intervention (PPCI) over tissue plasminogen activator (tPA) in the acute phase was maintained throughout the follow-up. In addition, and for the first time, in the subgroup of patients admitted to referral hospitals a significant benefit in terms of mortality emerged for PPCI-treated patients. Mortality was 26.7% with PPCI and 33.3% with tPA (a 6.6% absolute difference, odds ratio 0.78, 95%, confidence interval 0.63 to 0.97). On the other side, mortality was insignificantly higher with PPCI in the subgroup of patients admitted in invasive hospitals (a 4% absolute difference, 28.6% PPCI versus 24.6% tPA, odds ratio 1.17, …

circulation

Letter by Fresco Regarding Article “Primary Angioplasty Versus Fibrinolysis in Acute Myocardial Infarction: Long-Term Follow-Up in the Danish Acute Myocardial Infarction 2 Trial”