| Evolution in the practice of primary angioplasty: effect of adjunctive coronary stenting and glycoprotein IIb/IIIa inhibitors on long-term outcomes. | |
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MedLine Citation:
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PMID: 11747157 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Comparative Study; Evaluation Studies; Journal Article |
Journal Detail:
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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:
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Created Date: 2001-12-17 Completed Date: 2002-01-16 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: 327-32 Citation Subset: IM |
Copyright Information:
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Copyright 2001 Wiley-Liss, Inc. |
Affiliation:
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Cardiology Unit, Department of Medicine, University of Rochester Medical Center, Rochester, New York, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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0/Platelet Glycoprotein GPIIb-IIIa Complex |
| Comments/Corrections | |
Comment In:
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Catheter Cardiovasc Interv. 2001 Nov;54(3):333-4
[PMID:
11747158
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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