Document Detail


One-Week and 6-Month Cardiovascular Magnetic Resonance Outcome of the Pharmacoinvasive Strategy and Primary Angioplasty for the Reperfusion of ST-Segment Elevation Myocardial Infarction.
MedLine Citation:
PMID:  21255898     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
INTRODUCTION AND OBJECTIVES: Pharmacoinvasive strategy represents an attractive alternative to primary angioplasty. Using cardiovascular magnetic resonance imaging we compared the left ventricular outcome of the pharmacoinvasive strategy and primary angioplasty for the reperfusion of ST-segment elevation myocardial infarction. METHODS: Cardiovascular magnetic resonance was performed 1 week and 6 months after infarction in two consecutive cohorts of patients included in a prospective university hospital ST-segment elevation myocardial infarction registry. During the period 2004-2006, 151 patients were treated with pharmacoinvasive strategy (thrombolysis followed by routine non-immediate angioplasty). During the period 2007-2008, 93 patients were treated with primary angioplasty. A propensity score matched population was also evaluated. RESULTS: At 1-week cardiovascular magnetic resonance, pharmacoinvasive strategy and primary angioplasty patients showed a similar extent of area at risk (29±15 vs. 29±17%, P=.9). Non-significant differences were detected by cardiovascular magnetic resonance at 1 week and at 6 months in infarct size, salvaged myocardium, microvascular obstruction, ejection fraction, end-diastolic volume index and end-systolic volume index (P>.2 in all cases). The same trend was observed in 1-to-1 propensity score matched patients. The rate of major adverse cardiac events (death and/or re-infarction) at 1 year was 6% in pharmacoinvasive strategy and 7% in primary angioplasty patients (P=.7). CONCLUSIONS: A pharmacoinvasive strategy including thrombolysis and routine non-immediate angioplasty represents a widely available and logistically attractive approach that yields identical short-term and long-term cardiovascular magnetic resonance-derived left ventricular outcome compared to primary angioplasty. Full English text available from:www.revespcardiol.org.
Authors:
Vicente Bodí; Eva Rumiz; Pilar Merlos; Julio Nunez; Maria P López-Lereu; José V Monmeneu; Fabián Chaustre; David Moratal; Isabel Trapero; Maria L Blasco; Ricardo Oltra; Rafael Sanjuán; Francisco J Chorro; Angel Llàcer; Juan Sanchis
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-1-20
Journal Detail:
Title:  Revista espanola de cardiologia     Volume:  64     ISSN:  1579-2242     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0404277     Medline TA:  Rev Esp Cardiol     Country:  -    
Other Details:
Languages:  ENG; SPA     Pagination:  111-120     Citation Subset:  -    
Copyright Information:
Copyright © 2010 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.
Affiliation:
Departamento de Cardiología, Hospital Clínico Universitario, INCLIVA, Universidad de Valencia, Valencia, España.
Vernacular Title:
Resultados de la estrategia farmacoinvasiva y de la angioplastia primaria en la reperfusión del infarto con elevación del segmento ST. Estudio con resonancia magnética cardiaca en la primera semana y en el sexto mes.
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