Document Detail


Early coronary angioplasty for acute myocardial infarction: predictors of poor outcome in a non-selected population.
MedLine Citation:
PMID:  11231645     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: The objective of this study was to report the experience in the treatment of acute myocardial infarction (AMI) with early coronary angioplasty (PTCA) in a single European center during one decade, attempting to identify the characteristics associated with a poor prognosis in these patients. METHODS AND RESULTS: Eight hundred patients with AMI were treated with PTCA < 12 hours after symptom onset. Mean age was 64 +/- 13 years, 12% were in cardiogenic shock, AMI location was anterior in 61% and PTCA was performed after failed thrombolysis in 5%. Coronary stents and abciximab were used in 51% and 10%, respectively. An angiographic successful result was obtained in 93%, and final TIMI flow grade 3 was achieved in 83%. The overall in-hospital mortality rate was 12.5% (2.7%, 16.1%, 25.7% and 63.8% in patients in Killip class I, II, III and IV, respectively). Over the years, an improvement in the angiographic results and a reduction in the rates of reinfarction and target vessel revascularization were observed. The independent predictors of death were age > 70 years, absence of hyper-cholesterolemia, anterior location, cardiogenic shock, multi-vessel disease and unsuccessful PTCA. The leading causes of mortality were cardiogenic shock (63%) and ventricular free wall rupture (14%). The rates of non-fatal reinfarction, documented reocclusion and in-hospital repeated revascularization were 2%, 3% and 4%, respectively. CONCLUSION: In most cases, PTCA performed in a non-selected patient population with AMI results in angiographic success. Mortality especially occurs in patients who are in cardiogenic shock at the beginning of the procedure. We have observed an improvement in the results throughout the course of the decade.
Authors:
R Moreno; E García; J Soriano; M Abeytua; E López de Sá; J Acosta; L Péerez de Isla; R Rubio; J L López-Sendon
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  13     ISSN:  1042-3931     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2001 Mar 
Date Detail:
Created Date:  2001-03-20     Completed Date:  2001-05-17     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  202-10     Citation Subset:  IM    
Affiliation:
Cardiology Department, University General Hospital Gregorio Marañón, Doctor Esquerdo 46, 28007 Madrid, Spain.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary*
Antibodies, Monoclonal / therapeutic use
Coronary Angiography
Female
Hospital Mortality
Humans
Immunoglobulin Fab Fragments / therapeutic use
Male
Middle Aged
Myocardial Infarction / complications,  mortality,  radiography,  therapy*
Platelet Glycoprotein GPIIb-IIIa Complex / therapeutic use
Prognosis
Shock, Cardiogenic / complications,  mortality
Stents
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Immunoglobulin Fab Fragments; 0/Platelet Glycoprotein GPIIb-IIIa Complex; 143653-53-6/abciximab

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


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