| Comparison of primary angioplasty with conservative therapy in patients with acute myocardial infarction and contraindications for thrombolytic therapy. Maximal Individual Therapy in Acute Myocardial Infarction (MITRA) Study Group. | |
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MedLine Citation:
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PMID: 10348528 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The benefit of primary angioplasty in patients with acute myocardial infarction (AMI) and contraindications for thrombolysis compared to a conservative regimen is still unclear. Out of 5,869 patients with AMI registered by the MITRA trial, 337 (5.7%) patients had at least one strong contraindication for thrombolytic therapy. Out of these 337 patients 46 (13.6%) were treated with primary angioplasty and 276 (86.4%) were treated conservatively. Patients treated conservatively were older (70 years vs. 60 years; P=0.001), had a higher rate of a history with chronic heart failure (14.8% vs. 4.4%; P=0.053), a higher heart rate at admission (86 beats/min vs. 74 beats/min; P=0.001), and a higher prevalence of diabetes mellitus (27.1% vs. 12.8%; P=0.056). Patients treated with primary angioplasty received more often aspirin (91.3% vs. 74.6%; P=0.012), beta-blockers (60.9% vs. 46.1%; P = 0.062), angiotensin converting enzyme (ACE) inhibitors (71.7% vs. 44%; P=0.001), and the so-called optimal adjunctive medication (54.4% vs. 32.3%; P=0.004). Hospital mortality was significantly lower in patients who received primary angioplasty (univariate: 2.2% vs. 24.7%; P=0.001; multivariate: OR=0.46; P=0.0230). In patients with AMI and contraindications for thrombolytic therapy, primary angioplasty was associated with a significantly lower mortality compared to conservative treatment. Therefore, hospitals without the facilities to perform primary angioplasty should try to refer such patients to centers with the facilities for such a service, if this is possible in an acceptable time. |
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Authors:
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R Zahn; S Schuster; R Schiele; K Seidl; T Voigtländer; J Meyer; K E Hauptmann; M Gottwik; G Berg; T Kunz; U Gieseler; M Jakob; J Senges |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions Volume: 46 ISSN: 1522-1946 ISO Abbreviation: Catheter Cardiovasc Interv Publication Date: 1999 Feb |
Date Detail:
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Created Date: 1999-07-06 Completed Date: 1999-07-06 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 100884139 Medline TA: Catheter Cardiovasc Interv Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 127-33 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Herzzentrum Ludwigshafen, Germany. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angioplasty, Transluminal, Percutaneous Coronary* Clinical Trials as Topic Female Germany Humans Male Middle Aged Multicenter Studies as Topic Myocardial Infarction / drug therapy, mortality, therapy* Survival Analysis Thrombolytic Therapy / contraindications* Treatment Outcome |
| Comments/Corrections | |
Comment In:
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Catheter Cardiovasc Interv. 1999 Feb;46(2):134
[PMID:
10348529
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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