Document Detail


Evolution in the practice of primary angioplasty: effect of adjunctive coronary stenting and glycoprotein IIb/IIIa inhibitors on long-term outcomes.
MedLine Citation:
PMID:  11747157     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Primary angioplasty strategies have evolved dramatically, including increasing adjunctive use of stents and glycoprotein (GP) IIb/IIIa inhibitors. The purpose of this study was to examine the specific effects of these adjunctive therapies on long-term outcomes after primary angioplasty. From 1996 to 1998, 257 unselected, consecutive patients underwent primary PTCI at our institution. In-hospital mortality was 5.4% (2.9% for patients without cardiogenic shock). The remaining 243 patients were followed for 2.0 +/- 0.7 years. Adjunctive stenting was associated with increased late mortality (8.7% vs. 2.3%, P = 0.02). GP IIb/IIIa inhibitors were associated with reduced late mortality among patients receiving stents (6.9% vs. 21.4%, P = 0.07), but not in those patients treated with balloon angioplasty alone (2.9% vs. 0%, P > 0.20). Coronary stenting remained a significant predictor of late mortality (hazard ratio 5.6, 95% CI 1.5-21.2) after adjustment for other established risk factors. In this unselected series, adjunctive coronary stenting was associated with higher late mortality among hospital discharge survivors. Concomitant GP IIb/IIIa inhibitors partially corrected for this increase. These results are limited by the small sample size and retrospective design of this study. Additional long-term studies are required to test these findings and evaluate for possible mechanisms.
Authors:
V G Kalaria; I Chaudhary; S Jacobson; R M Pomerantz; C J Cove; F S Ling; D E Cutlip
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  54     ISSN:  1522-1946     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2001 Nov 
Date Detail:
Created Date:  2001-12-17     Completed Date:  2002-01-16     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  327-32     Citation Subset:  IM    
Copyright Information:
Copyright 2001 Wiley-Liss, Inc.
Affiliation:
Cardiology Unit, Department of Medicine, University of Rochester Medical Center, Rochester, New York, USA.
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Angioplasty, Transluminal, Percutaneous Coronary / trends*
Combined Modality Therapy / trends
Endpoint Determination
Female
Follow-Up Studies
Hospitalization
Humans
Male
Middle Aged
Myocardial Infarction / complications,  mortality,  therapy
New York / epidemiology
Platelet Glycoprotein GPIIb-IIIa Complex / antagonists & inhibitors,  therapeutic use
Predictive Value of Tests
Recurrence
Risk Factors
Shock, Cardiogenic / complications,  mortality
Stents / trends
Survival Analysis
Time
Treatment Outcome
Chemical
Reg. No./Substance:
0/Platelet Glycoprotein GPIIb-IIIa Complex
Comments/Corrections
Comment In:
Catheter Cardiovasc Interv. 2001 Nov;54(3):333-4   [PMID:  11747158 ]

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


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