| In-hospital cardiac mortality after acute closure after coronary angioplasty: analysis of risk factors from 8,207 procedures. | |
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MedLine Citation:
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PMID: 2963055 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Cardiac death consequent to acute vessel closure after coronary angioplasty occurred in 13 of 294 closures from 8,207 consecutive procedures performed at two centers since 1981 (0.16% cardiac mortality rate). To determine the predictors of cardiac death after acute coronary closure, 50 clinical, angiographic and procedural variables were analyzed by an observer unaware of the clinical outcome for each of the 13 patients who died and also 100 patients randomly chosen, in whom vessel closure after angioplasty did not result in death during hospitalization. Univariate analysis found female gender (p less than 0.0001), collateral channels from the vessel dilated (p less than 0.0001), use of balloon counterpulsation (p less than 0.0002), pre- and postprocedural hypotension (p = 0.0003 and p = 0.003, respectively), jeopardy score greater than or equal to 2.5 (p = 0.003), left ventricular hypertrophy (p = 0.013), hypertension (p = 0.02), diabetes (p = 0.02) and multivessel disease (p = 0.03) to be predictive of death. Multivariate analysis found collateral vessels, female gender and multivessel disease to be independent predictors of death. Thus, cardiac death after elective coronary angioplasty is very rare in experienced centers and occurs most often in women with a large amount of potentially ischemic myocardium. Hypotension often precedes the fatal closure event. Close attention to the amount of potentially ischemic myocardium and to the fluid volume status of these patients would seem to be especially warranted. |
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Authors:
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S G Ellis; G S Roubin; S B King; J S Douglas; R E Shaw; S H Stertzer; R K Myler |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 11 ISSN: 0735-1097 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 1988 Feb |
Date Detail:
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Created Date: 1988-03-02 Completed Date: 1988-03-02 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 211-6 Citation Subset: AIM; IM |
Affiliation:
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Andreas Gruentzig Cardiovascular Center, Emory University School of Medicine, Atlanta, Georgia 30322. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Angioplasty, Balloon / mortality* Cardiomegaly / complications Coronary Disease / mortality*, therapy Diabetes Mellitus, Type 1 / complications Female Hospitalization Humans Male Middle Aged Risk Factors Sex Factors Time Factors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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