Document Detail

Long-term clinical outcome of rescue balloon angioplasty compared with rescue stenting after failed thrombolysis.
MedLine Citation:
PMID:  11975796     Owner:  NLM     Status:  MEDLINE    
Failed thrombolysis following acute myocardial infarction is associated with a poor prognosis. Balloon angioplasty with or without stenting is an established procedure in acute myocardial infarction and for failed thrombolysis (rescue percutaneous transluminal coronary angioplasty [PTCA]). Intracoronary stenting improves initial success rates, decreases incidence of abrupt closure, and reduces the rate of restenosis after angioplasty. The purpose of this study was to compare the effect of rescue PTCA with rescue stenting in the treatment of acute myocardial infarction after failed thrombolysis. Clinical data are from a retrospective review of 102 patients requiring rescue balloon angioplasty or stenting after failed thrombolysis for acute myocardial infarction. There was a greater incidence of recurrent angina in 11 patients (22%) in the rescue PTCA group versus 2 patients (4%) in the rescue stenting group. The in-hospital recurrent myocardial infarction rate was 14% in the rescue PTCA group versus 2% in the stented group. In the rescue PTCA cohort, 11 patients (22%) required in-hospital repeat revascularization versus 2 patients in the stented group. The in-hospital mortality rate was higher in the PTCA group (10%) versus that in the stent group (2%). There was no significant difference in the incidence of postdischarge deaths. Rescue stenting is superior to rescue angioplasty. The procedure is associated with lower in-hospital angina and recurrent myocardial infarction, and the need for fewer repeat revascularizations. Long-term patients treated with stents required fewer revascularization procedures. Overall, rescue stenting was associated with a significantly lower mortality.
S Koneru; C E Monsen; A Pucillo; M B Cohen; J A McClung; M B Weiss
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Heart disease (Hagerstown, Md.)     Volume:  3     ISSN:  1521-737X     ISO Abbreviation:  Heart Dis     Publication Date:    2001 Jul-Aug
Date Detail:
Created Date:  2002-04-26     Completed Date:  2002-05-29     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100887299     Medline TA:  Heart Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  217-20     Citation Subset:  IM    
Department of Medicine, Division of Cardiology, New York Medical College/Westchester Medical Center, Valhalla, New York 10595, USA.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary*
Blood Vessel Prosthesis Implantation
Combined Modality Therapy
Coronary Artery Bypass
Endpoint Determination
Follow-Up Studies
Middle Aged
Myocardial Infarction / mortality,  therapy
Patient Discharge
Survival Analysis
Thrombolytic Therapy*
Treatment Outcome

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

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