| Invasive strategy following fibrinolysis in ST-elevation acute myocardial infarction. | |
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MedLine Citation:
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PMID: 15568598 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: A recognized drawback of ST-elevation acute myocardial infarction (STEMI) after fibrinolysis is persistent coronary occlusion or a less than TIMI 3 flow. The present study describes the results of systematic pre-discharge coronary angiography and revascularization, whenever indicated, following fibrinolytic therapy for STEMI. METHODS: Consecutive patients admitted with the diagnosis of STEMI between April 1, 2000 and April 30, 2002 were included in the study. Patients with contraindications to thrombolytic therapy and/or patients not eligible for angiography were excluded. All patients received "accelerated" treatment with alteplase and had a coronary angiography at least 24 hours later, in order to perform, if anatomically feasible, angioplasty with stenting. Angioplasty of non-infarct-related coronary arteries was allowed. The mortality, reinfarction and new revascularization rates were evaluated during index hospitalization and up to 30 days and 6 months. RESULTS: Eighty patients underwent cardiac catheterization at a median of 6.5 days following admission; in 86.3% of cases a patent infarct-related artery was found; in 71% of patients a coronary angioplasty was performed, with stenting in 88% of cases. Procedure-related complications were infrequent. No deaths occurred during hospitalization and at 30 days; at 6 months the mortality rate was 1.3%. In-hospital reinfarction occurred in 3.8% of patients, in 4% at 30 days and in 5.3% at 6 months. The rate of any new revascularization was 2.6% at 30 days and 11% at 6 months. CONCLUSIONS: Although obtained in a small observational study, our data, unlike those from previous studies, suggest that an invasive strategy after fibrinolysis in STEMI is safe and associated with low mortality and morbidity rates in the short and medium-terms. |
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Authors:
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Rodolfo Pino; Francesco Clemenza; Caterina Gandolfo; Lucrezia Lo Cascio; Francesco Lo Giudice; Ubaldo Pulisano; Amerigo Stabile |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Italian heart journal : official journal of the Italian Federation of Cardiology Volume: 5 ISSN: 1129-471X ISO Abbreviation: Ital Heart J Publication Date: 2004 Sep |
Date Detail:
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Created Date: 2004-11-30 Completed Date: 2005-02-10 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 100909716 Medline TA: Ital Heart J Country: Italy |
Other Details:
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Languages: eng Pagination: 688-92 Citation Subset: IM |
Affiliation:
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Division of Cardiology, Cefalú Hospital, ASL 6 Palermo, Cefalú (PA), Italy. rodoraffa@tiscali.it |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angioplasty, Transluminal, Percutaneous Coronary / methods* Cohort Studies Combined Modality Therapy Coronary Angiography Electrocardiography* Female Fibrinolytic Agents / therapeutic use* Heart Catheterization Hospital Mortality* Humans Male Middle Aged Myocardial Infarction / diagnosis*, mortality, therapy* Prognosis Prospective Studies Risk Assessment Severity of Illness Index Survival Analysis Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Fibrinolytic Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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