Document Detail


Culprit vessel PCI versus traditional cath and PCI for STEMI.
MedLine Citation:
PMID:  18460706     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare door-to-balloon times with culprit vessel percutaneous coronary intervention (PCI) as initial treatment for ST-elevation myocardial infarction (STEMI) to traditional complete coronary angiography followed by PCI for treatment of STEMI. BACKGROUND: Shorter door-to-balloon time for STEMI treatment is associated with better outcomes, and is generally achieved by shortening the door-to-vascular access time. Whether procedural improvements can shorten the vascular access-to-balloon time has not been examined. METHODS: Door-to-balloon times were assessed in 50 consecutive patients who underwent initial PCI of the culprit vessel for STEMI at Wake Forest University Baptist Medical Center, and in 85 consecutive patients who underwent traditional coronary angiography followed by PCI for STEMI. RESULTS: Procedural success was 100% in both groups. Door-to-balloon times were 66 +/- 20 minutes for culprit PCI vs. 79 +/- 28 minutes for traditional PCI, p < 0.001, due to shorter vascular access-to-balloon time, 11 +/- 8 minutes for culprit PCI vs. 18 +/- 8 minutes for traditional PCI, p < 0.001. 92% of the culprit PCI group had a door-to-balloon time < 90 minutes, compared to 76% in the traditional group, p = 0.023. Subsequent planned revascularization procedures were infrequent and similar in both groups. CONCLUSIONS: In this small pilot study, performing PCI of the culprit vessel for STEMI as initial treatment resulted in a decrease in the door-to-balloon time compared to traditional coronary angiography followed by PCI without compromising subsequent cardiac care. Whether broader utilization of this strategy will result in beneficial outcomes remains to be determined.
Authors:
Robert J Applegate; Stacy H Graham; Sanjay K Gandhi; Michael A Kutcher; Matthew T Sacrinty; Renato M Santos; William C Little
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  20     ISSN:  1557-2501     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-05-07     Completed Date:  2008-07-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  224-8     Citation Subset:  IM    
Affiliation:
Section of Cardiology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157-1045, USA. bapplega@wfubmc.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary*
Coronary Angiography
Female
Humans
Male
Middle Aged
Myocardial Infarction / radiography,  therapy*
Myocardial Revascularization
Pilot Projects
Treatment Outcome
Comments/Corrections
Comment In:
J Invasive Cardiol. 2008 May;20(5):229-30   [PMID:  18460707 ]

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


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