THE WESTERN WASHINGTON AND MYOCARDIAL-INFARCTION TRIAGE AND INTERVENTION TRIALS OF THROMBOLYTIC THERAPY - 15 YEARS OF COLLABORATION IN THE PACIFIC-NORTHWEST

Beginning in 1981, collaborative efforts developed between the Univers ity of Washington and community hospitals in Washington, British Colum bia, Canada, and later outside the Pacific Northwest, have generated i mportant findings about the treatment and outcome of acute myocardial infarction (AMI). These efforts, collectively known as the Western Was hington and Myocardial Infarction Triage and Intervention Project tria ls, have included randomized trials of thrombolytic drugs, direct anti thrombins, platelet receptors, antagonists, and cell adhesion blockers , as well as the formation of registries of consecutive patients admit ted to coronary care units with the diagnosis of suspected AMI. Result s of these trials have demonstrated that thrombolytic therapy signific antly reduces mortality and morbidity from AMI with minimal risk to pa tients, and that early treatment is associated with improved infarct s ize and better left ventricular function. The efforts of the next deca de should be focused on the further removal of barriers to rapid treat ment and to the evaluation of new agents, so that the devastating effe cts of myocardial infarction are minimized to the fullest extent.