| Acute myocardial infarction complicated by early onset of heart failure: safety and feasibility of interhospital transfer for coronary angioplasty. Subanalysis of Killip II-IV patients from the PRAGUE-1 study. | |
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MedLine Citation:
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PMID: 12800397 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The objective of this study is to assess the feasibility and safety of interhospital transfer (within up to 60 minutes) for primary/rescue coronary angioplasty of patients with myocardial infarction (AMI) complicated by an early onset of acute heart failure (AHF) admitted to a community hospital without PCI facilities. DESIGN AND PATIENTS: From the multicenter randomized PRAGUE-1 study, a subgroup of 66 patients with AMI complicated by AHF on the first presentation to the community hospital were retrospectively analyzed. Group A patients (n = 21) were treated on site in community hospitals using thrombolysis (streptokinase), group B patients (n = 20) were transported with thrombolytic infusion to a PCI center for coronary angioplasty, and group C patients (n = 25) were immediately transported to a PCI center for primary angioplasty without thrombolysis. RESULTS: No patient died during transportation. One group B patient developed ventricular fibrillation during transfer. The time delay from the onset of chest pain to reperfusion was > 142 minutes, and 253 and 251 minutes in groups A, B, and C, respectively. Hospital stay (16 vs 11 vs 10 days, P = NS) was shorter in the angioplasty groups. Transported patients (groups B, C) displayed a significant decrease in heart failure progression within the first 24 hours after treatment (48% vs 15% vs 8%, P < 0.05). The combined end point, i.e., mortality + nonfatal reinfarction (43% vs 25% vs 8%, P < 0.05), was significantly less frequent in the coronary angioplasty group. CONCLUSIONS: Interhospital transfer for coronary angioplasty of patients with AMI complicated by an early onset of AHF is feasible and safe. Transport for angioplasty may even reduce the risk of heart failure progression and improve clinical outcome compared to immediate thrombolysis in the nearest community hospital. |
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Authors:
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Frantisek Bednár; Petr Widimský; Ladislav Groch; Michael Aschermann; Michael Zelízko; Jirí Krupicka; |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: Journal of interventional cardiology Volume: 16 ISSN: 0896-4327 ISO Abbreviation: J Interv Cardiol Publication Date: 2003 Jun |
Date Detail:
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Created Date: 2003-06-12 Completed Date: 2003-07-11 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8907826 Medline TA: J Interv Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 201-8 Citation Subset: IM |
Affiliation:
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Cardiocenter, University Hospital Vinohrady, Prague, Czech Republic. widim@fnkv.cz |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angioplasty, Transluminal, Percutaneous Coronary* Coronary Angiography Disease Progression Feasibility Studies Female Heart Failure / complications*, mortality, therapy* Hospital Mortality Humans Length of Stay Male Middle Aged Myocardial Infarction / complications*, mortality, therapy* Patient Transfer* Stroke Volume / physiology Time Factors Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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