Document Detail


Comparison of protective effects of preinfarction angina pectoris in acute myocardial infarction treated by thrombolysis versus by primary coronary angioplasty with stenting.
MedLine Citation:
PMID:  10498128     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The protective effects of preinfarction angina were evaluated in acute myocardial infarction (AMI) treated by primary percutaneous transluminal coronary angioplasty (PTCA) and stenting. We studied 613 patients with AMI. Group 1 (n = 306) was treated by conventional medical therapies and coronary thrombolysis and group 2 (n = 307) was treated by primary PTCA supported by stenting. Each group was subdivided into those with and without preinfarction angina within 24 hours before the onset of AMI. There was no significant difference in clinical characteristics between the subgroups of groups 1 and 2. In group 1, there were differences between patients with preinfarction angina (n = 84) and those without (n = 222) in in-hospital mortality (11% vs 18%), pump failure (Killip classes 3 and 4) (11% vs 21%, p <0.05), left ventricular ejection fraction at discharge (52 +/- 13% vs 48 +/- 14%, p <0.05), and peak creatine kinase (2,106 +/- 1,637 vs 2,764 +/- 2,154 U/L, p <0.02). In group 2, however, there was no significant difference between those with preinfarction angina (n = 82) and those without (n = 225) in mortality (6% vs 6%), pump failure (12% vs 12%), left ventricular ejection fraction (50 +/- 13% vs 50 +/- 13%) and peak creatine kinase (3,285 +/- 2,306 vs 3,291 +/- 2,262 U/L). Multivariate analysis indicated that preinfarction angina was an independent determinant of in-hospital death and pump failure in group 1, but not in group 2. We conclude that the protective effects of preinfarction angina in AMI are not evident in those treated by primary PTCA and stenting, possibly because of the overwhelming protective effects of complete coronary revascularization provided by primary PTCA and stenting.
Authors:
H Tomoda; N Aoki
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  84     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1999 Sep 
Date Detail:
Created Date:  1999-10-06     Completed Date:  1999-10-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  621-5     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, Tokai University, Kanagawa, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angina Pectoris / diagnosis,  mortality,  therapy*
Angioplasty, Transluminal, Percutaneous Coronary*
Coronary Angiography
Female
Hospital Mortality
Humans
Ischemic Preconditioning, Myocardial*
Male
Middle Aged
Myocardial Infarction / diagnosis,  mortality,  therapy*
Prognosis
Retrospective Studies
Stents*
Stroke Volume / physiology
Survival Rate
Thrombolytic Therapy*
Tissue Plasminogen Activator / administration & dosage
Chemical
Reg. No./Substance:
EC 3.4.21.68/Tissue Plasminogen Activator

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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