Document Detail


Early and late results of coronary angioplasty without antecedent thrombolytic therapy for acute myocardial infarction.
MedLine Citation:
PMID:  2589185     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Direct coronary angioplasty without antecedent thrombolytic therapy was performed in 500 consecutive patients with acute myocardial infarction. Anterior and inferior infarctions were noted in 217 and 283 patients, respectively. Two hundred fifteen patients (43%) had 1-vessel disease, 85 patients (17%) were greater than 70 years of age and 39 (8%) presented in cardiogenic shock. Successful angioplasty of the infarct vessel was achieved in 94% of patients. The overall in-hospital mortality was 7.2%. Cardiogenic shock, 3-vessel disease and failed angioplasty were the 3 strongest multivariate correlates of early mortality. Reocclusion of the infarct-vessel was noted in 47 (15%) of the 307 patients with angiographic follow-up before hospital discharge. Significant bleeding complications occurred in only 3% of patients; stroke or myocardial rupture was not seen. The global ejection fraction increased from 53% on the preangioplasty ventriculograms to 59% at 1 week (p less than 0.001). Significant regional wall motion improvement in the infarct segments was noted in 53% of patients. Global ejection fraction improved most dramatically in patients presenting with baseline ejection fractions less than or equal to 45% (increasing from 36 to 50%). The 1- and 5-year survival rates after hospital discharge were 95 and 84%, respectively. The 1-year reinfarction rate was 3%. Thus, direct coronary angioplasty was highly effective in reestablishing infarct-vessel patency and salvaging ischemic myocardium, resulting in low in-hospital and long-term mortality.
Authors:
J H O'Keefe; B D Rutherford; D R McConahay; R W Ligon; W L Johnson; L V Giorgi; J E Crockett; B D McCallister; R D Conn; G M Gura
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  64     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1989 Dec 
Date Detail:
Created Date:  1990-01-11     Completed Date:  1990-01-11     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1221-30     Citation Subset:  AIM; IM    
Affiliation:
Cardiovascular Consultants, Kansas City, Missouri 64111.
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Transluminal, Percutaneous Coronary* / mortality
Evaluation Studies as Topic
Follow-Up Studies
Heart / physiopathology
Heart Ventricles
Hospitalization
Humans
Morbidity
Myocardial Infarction / mortality,  physiopathology,  therapy*
Postoperative Complications
Survival Analysis
Time Factors

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


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