| Elective coronary stent implantation in cardiogenic shock complicating acute myocardial infarction: in-hospital and six-month clinical and angiographic results. | |
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MedLine Citation:
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PMID: 10931605 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Effective treatment of patients with acute myocardial infarction and cardiogenic shock depends on restoring persistent patency of the infarct-related artery. Coronary stenting, reducing abrupt or delayed closure related to dissection and suboptimal result, may improve PTCA results in cardiogenic shock. Eighteen patients (14 males and 4 females, mean age 59 +/- 7 years), referred to catheterization laboratory for acute myocardial infarction and shock, had elective stent implantation during 14 primary and 4 rescue PTCA. Time delay between shock onset and PTCA was 4.1 +/- 3 hr (range, 30 min to 12 hr). The IRA was LAD in seven patients (38%), LCx in two (11%), and RCA in eight (45%). One patient (5.%) had distal LMCA occlusion. Stent deployment was successful in 100% of patients and resulted in TIMI 3 flow in 13 (72%) patients. In 13 (72%) cases, cardiogenic shock gradually resolved and the patients were discharged alive. Five patients (28%) died because of irreversible hemodynamic deterioration without evidence of reinfarction. At 6-month follow-up, all the discharged patients were alive and no patient had reinfarction or recurrent angina. Heart transplant was required in one patient 5 months after stenting because of refractory congestive heart failure. Angiography demonstrated patency of all the coronary arteries treated, with TIMI 3 flow in all patients. Stent restenosis rate was 30%, and target lesion revascularization with CABG or re-PTCA was not required in any case. LV function improved from 39% +/- 15% to 51% +/- 15% (P < 0.01). Elective coronary stenting is an effective treatment for acute myocardial infarction complicated by cardiogenic shock and may improve acute and long-term survival. |
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Authors:
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F Fabbiocchi; A L Bartorelli; P Montorsi; S Cozzi; D Trabattoni; G Calligaris; A Loaldi |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions Volume: 50 ISSN: 1522-1946 ISO Abbreviation: Catheter Cardiovasc Interv Publication Date: 2000 Aug |
Date Detail:
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Created Date: 2000-09-15 Completed Date: 2000-09-15 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 100884139 Medline TA: Catheter Cardiovasc Interv Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 384-9 Citation Subset: IM |
Affiliation:
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Institute of Cardiology, University of Milan, Fondazione "Monzino" Italy. ffabbiocchi@cardiologicomonzino.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angioplasty, Transluminal, Percutaneous Coronary / methods* Coronary Angiography* Disease-Free Survival Electrocardiography Female Follow-Up Studies Humans Male Middle Aged Myocardial Infarction / complications*, physiopathology, radiography, surgery Retrospective Studies Shock, Cardiogenic / etiology, physiopathology, radiography, surgery* Stents* Surgical Procedures, Elective* Ventricular Function, Left |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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