Myocardial Infarction Triage and Intervention Project (MITI)

Summary

To determine the practicality, benefit, and safety of paramedic administration of thrombolytic therapy for acute myocardial infarction. The feasibility of paramedics correctly identifying candidates for thrombolytic therapy following myocardial infarction was assessed in Phase I. In Phase II, pre-hospital thrombolytic therapy was compared with in-hospital thrombolytic therapy.

Timeline

Start

1988-04

Primary completion

—

Completion

1992-03

Publications

• Background Every NR, Parsons LS, Hlatky M, Martin JS, Weaver WD. A comparison of thrombolytic therapy with primary coronary angioplasty for acute myocardial infarction. Myocardial Infarction Triage and Intervention Investigators. N Engl J Med. 1996 Oct 24;335(17):1253-60. doi: 10.1056/NEJM199610243351701.
• Background Every NR, Maynard C, Cochran RP, Martin J, Weaver WD. Characteristics, management, and outcome of patients with acute myocardial infarction treated with bypass surgery. Myocardial Infarction Triage and Intervention Investigators. Circulation. 1996 Nov 1;94(9 Suppl):II81-6.
• Background Weaver WD, Eisenberg MS, Martin JS, Litwin PE, Shaeffer SM, Ho MT, Kudenchuk P, Hallstrom AP, Cerqueira MD, Copass MK, et al. Myocardial Infarction Triage and Intervention Project--phase I: patient characteristics and feasibility of prehospital initiation of thrombolytic therapy. J Am Coll Cardiol. 1990 Apr;15(5):925-31. doi: 10.1016/0735-1097(90)90218-e.
• Background Martin JS, Litwin PE, Weaver WD. Early recognition and treatment of the patient suffering from acute myocardial infarction. A description of the Myocardial Infarction Triage and Intervention Project. Crit Care Nurs Clin North Am. 1990 Dec;2(4):681-8.
• Background Kennedy JW, Weaver WD. The potential for prehospital thrombolytic therapy. Clin Cardiol. 1990 Aug;13(8 Suppl 8):VIII23-6.
• Background Kudenchuk PJ, Ho MT, Weaver WD, Litwin PE, Martin JS, Eisenberg MS, Hallstrom AP, Cobb LA, Kennedy JW. Accuracy of computer-interpreted electrocardiography in selecting patients for thrombolytic therapy. MITI Project Investigators. J Am Coll Cardiol. 1991 Jun;17(7):1486-91. doi: 10.1016/0735-1097(91)90636-n.
• Background Weaver WD, Litwin PE, Martin JS, Kudenchuk PJ, Maynard C, Eisenberg MS, Ho MT, Cobb LA, Kennedy JW, Wirkus MS. Effect of age on use of thrombolytic therapy and mortality in acute myocardial infarction. The MITI Project Group. J Am Coll Cardiol. 1991 Sep;18(3):657-62. doi: 10.1016/0735-1097(91)90784-7.
• Background Maynard C, Litwin PE, Martin JS, Cerqueira M, Kudenchuk PJ, Ho MT, Kennedy JW, Cobb LA, Schaeffer SM, Hallstrom AP, et al. Characteristics of black patients admitted to coronary care units in metropolitan Seattle: results from the Myocardial Infarction Triage and Intervention Registry (MITI). Am J Cardiol. 1991 Jan 1;67(1):18-23. doi: 10.1016/0002-9149(91)90092-y.
• Background Hallstrom AP, Litwin PE, Weaver WD. A method of assigning scores to the components of a composite outcome: an example from the MITI trial. Control Clin Trials. 1992 Apr;13(2):148-55. doi: 10.1016/0197-2456(92)90020-z.
• Background Maynard C, Litwin PE, Martin JS, Weaver WD. Gender differences in the treatment and outcome of acute myocardial infarction. Results from the Myocardial Infarction Triage and Intervention Registry. Arch Intern Med. 1992 May;152(5):972-6.
• Background Every NR, Larson EB, Litwin PE, Maynard C, Fihn SD, Eisenberg MS, Hallstrom AP, Martin JS, Weaver WD. The association between on-site cardiac catheterization facilities and the use of coronary angiography after acute myocardial infarction. Myocardial Infarction Triage and Intervention Project Investigators. N Engl J Med. 1993 Aug 19;329(8):546-51. doi: 10.1056/NEJM199308193290807.
• Background Weaver WD, Cerqueira M, Hallstrom AP, Litwin PE, Martin JS, Kudenchuk PJ, Eisenberg M. Prehospital-initiated vs hospital-initiated thrombolytic therapy. The Myocardial Infarction Triage and Intervention Trial. JAMA. 1993 Sep 8;270(10):1211-6.
• Background Longstreth WT Jr, Litwin PE, Weaver WD. Myocardial infarction, thrombolytic therapy, and stroke. A community-based study. The MITI Project Group. Stroke. 1993 Apr;24(4):587-90. doi: 10.1161/01.str.24.4.587.
• Background Maynard C, Weaver WD, Litwin PE, Martin JS, Kudenchuk PJ, Dewhurst TA, Eisenberg MS, Hallstrom AP, Chambers J. Hospital mortality in acute myocardial infarction in the era of reperfusion therapy (the Myocardial Infarction Triage and Intervention Project). Am J Cardiol. 1993 Oct 15;72(12):877-82. doi: 10.1016/0002-9149(93)91099-4.
• Background Weaver WD, Litwin PE, Martin JS. Use of direct angioplasty for treatment of patients with acute myocardial infarction in hospitals with and without on-site cardiac surgery. The Myocardial Infarction, Triage, and Intervention Project Investigators. Circulation. 1993 Nov;88(5 Pt 1):2067-75. doi: 10.1161/01.cir.88.5.2067.
• Background Every NR, Fihn SD, Maynard C, Martin JS, Weaver WD. Resource utilization in treatment of acute myocardial infarction: staff-model health maintenance organization versus fee-for-service hospitals. The MITI Investigators. Myocardial Infarction Triage and Intervention. J Am Coll Cardiol. 1995 Aug;26(2):401-6. doi: 10.1016/0735-1097(95)80013-7.
• Background Kudenchuk PJ, Maynard C, Martin JS, Wirkus M, Weaver WD. Comparison of presentation, treatment, and outcome of acute myocardial infarction in men versus women (the Myocardial Infarction Triage and Intervention Registry). Am J Cardiol. 1996 Jul 1;78(1):9-14. doi: 10.1016/s0002-9149(96)00218-4.
• Background Every NR, Spertus J, Fihn SD, Hlatky M, Martin JS, Weaver WD. Length of hospital stay after acute myocardial infarction in the Myocardial Infarction Triage and Intervention (MITI) Project registry. J Am Coll Cardiol. 1996 Aug;28(2):287-93. doi: 10.1016/0735-1097(96)00168-4.
• Background Brouwer MA, Martin JS, Maynard C, Wirkus M, Litwin PE, Verheugt FW, Weaver WD. Influence of early prehospital thrombolysis on mortality and event-free survival (the Myocardial Infarction Triage and Intervention [MITI] Randomized Trial). MITI Project Investigators. Am J Cardiol. 1996 Sep 1;78(5):497-502. doi: 10.1016/s0002-9149(96)00352-9.
• Background Spertus JA, Weiss NS, Every NR, Weaver WD. The influence of clinical risk factors on the use of angiography and revascularization after acute myocardial infarction. Myocardial Infarction Triage and Intervention Project Investigators. Arch Intern Med. 1995 Nov 27;155(21):2309-16.
• Background Maynard C, Every NR, Litwin PE, Martin JS, Weaver WD. Outcomes in African-American women with suspected acute myocardial infarction: the Myocardial Infarction Triage and Intervention Project. J Natl Med Assoc. 1995 May;87(5):339-44.
• Background Every NR, Parsons LS, Fihn SD, Larson EB, Maynard C, Hallstrom AP, Martin JS, Weaver WD. Long-term outcome in acute myocardial infarction patients admitted to hospitals with and without on-site cardiac catheterization facilities. MITI Investigators. Myocardial Infarction Triage and Intervention. Circulation. 1997 Sep 16;96(6):1770-5. doi: 10.1161/01.cir.96.6.1770.
• Background Maynard C, Every NR, Martin JS, Weaver WD. Long-term implications of racial differences in the use of revascularization procedures (the Myocardial Infarction Triage and Intervention registry). Am Heart J. 1997 Jun;133(6):656-62. doi: 10.1016/s0002-8703(97)70167-4.
• Background Kudenchuk PJ, Maynard C, Cobb LA, Wirkus M, Martin JS, Kennedy JW, Weaver WD. Utility of the prehospital electrocardiogram in diagnosing acute coronary syndromes: the Myocardial Infarction Triage and Intervention (MITI) Project. J Am Coll Cardiol. 1998 Jul;32(1):17-27. doi: 10.1016/s0735-1097(98)00175-2.
• Background Scull GS, Martin JS, Weaver WD, Every NR. Early angiography versus conservative treatment in patients with non-ST elevation acute myocardial infarction: MITI Investigators. Myocardial Infarction Triage and Intervention. J Am Coll Cardiol. 2000 Mar 15;35(4):895-902. doi: 10.1016/s0735-1097(99)00643-9.
• Background Maynard C, Martin JS, Hallstrom AP, Weaver WD. Changes in the Use of Thrombolytic Therapy in Seattle Area Hospitals from 1988 to 1992: Results from the Myocardial Infarction Triage and Intervention Registry. J Thromb Thrombolysis. 1995;1(2):195-199. doi: 10.1007/BF01062578.
• Background Kim C, Schaaf CH, Maynard C, Every NR. Unstable angina in the myocardial infarction triage and intervention registry (MITI): short- and long-term outcomes in men and women. Am Heart J. 2001 Jan;141(1):73-7. doi: 10.1067/mhj.2001.111546.

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