Document Detail


Coronary angioplasty after recombinant tissue-type plasminogen activator in acute myocardial infarction: a report from the Thrombolysis in Myocardial Infarction (TIMI) Trial.
MedLine Citation:
PMID:  2959715     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To assess the utility of percutaneous transluminal coronary angioplasty after successful thrombolytic therapy for patients with acute myocardial infarction, the outcome of 201 patients who received intravenous recombinant tissue-type plasminogen activator (rt-PA) was analyzed. Reperfusion of the infarct-related artery was observed in 132 patients who were assessed for potential coronary angioplasty at 18 to 48 hours after treatment. Coronary angioplasty was performed in 52 patients (39%). Reasons for not performing angioplasty included unsuitable coronary anatomy, presence of residual stenosis of less than 60% and the need to perform an earlier procedure. When attempted, coronary angioplasty was successful in 96% of patients and was associated with a decrease in coronary stenosis from 85 to 30%. No patient experienced a major complication associated with coronary angioplasty. Of 36 patients undergoing predischarge coronary angiography after successful angioplasty, the infarct-related artery remained patent in 97.2%. Thus, coronary angioplasty is feasible and safe in patients who achieve coronary reperfusion after intravenous rt-PA for acute myocardial infarction. Not all patients who achieve reperfusion, however, are suitable for coronary angioplasty. When attempted, angioplasty is usually successful and associated with sustained patency of the infarct-related artery.
Authors:
D O Williams; N A Ruocco; S Forman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  10     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1987 Nov 
Date Detail:
Created Date:  1987-12-04     Completed Date:  1987-12-04     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  45B-50B     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Rhode Island Hospital, Brown University, Providence 02903.
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Balloon* / adverse effects
Combined Modality Therapy
Coronary Angiography
Coronary Vessels*
Drug Evaluation
Evaluation Studies as Topic
Humans
Myocardial Infarction / therapy*
Random Allocation
Recombinant Proteins / therapeutic use
Recurrence
Time Factors
Tissue Plasminogen Activator / therapeutic use*
Chemical
Reg. No./Substance:
0/Recombinant Proteins; 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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