| Percutaneous coronary intervention for acute MI does not prevent in-hospital development of cardiogenic shock compared to fibrinolysis. | |
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MedLine Citation:
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PMID: 18571985 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: It has been speculated that invasive revascularization prevents development of cardiogenic shock. Data from randomised trials comparing angioplasty with fibrinolysis on the development of cardiogenic shock are lacking. AIMS: To elucidate the effect of angioplasty on in-hospital development of cardiogenic shock compared to fibrinolysis. To evaluate whether mortality in patients who develop cardiogenic shock after treatment is dependent on revascularization strategy. METHODS AND RESULTS: DANAMI-2 randomly assigned 1572 STEMI patients to fibrinolysis (782 patients) or angioplasty (790 patients). Data on patients with in-hospital development of cardiogenic shock after randomisation were included. Of the 103 patients (6.6%) patients developing cardiogenic shock 57% were randomised to angioplasty with an unadjusted odds ratio of 1.39 (0.92-2.11, p=0.14). During the three year follow-up 58% of the total mortality was due to cardiogenic shock, and treatment strategy did not influence the risk associated with shock (hazard ratio of 1.05 (0.67-1.64) for angioplasty vs. fibrinolysis). CONCLUSIONS: Angioplasty does not prevent the in-hospital development of cardiogenic shock complicating acute MI compared to fibrinolysis. Cardiogenic shock is still the leading cause of death in patients hospitalised for acute MI. There was no difference in mortality, with regards to treatment strategy in patients developing cardiogenic shock after the initial treatment. |
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Authors:
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Matias G Lindholm; Søren Boesgaard; Jens Jakob Thune; Henning Kelbaek; Henning Rud Andersen; Lars Kober; |
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Publication Detail:
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Type: Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2008-06-20 |
Journal Detail:
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Title: European journal of heart failure Volume: 10 ISSN: 1388-9842 ISO Abbreviation: Eur. J. Heart Fail. Publication Date: 2008 Jul |
Date Detail:
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Created Date: 2008-07-08 Completed Date: 2008-12-16 Revised Date: 2011-06-08 |
Medline Journal Info:
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Nlm Unique ID: 100887595 Medline TA: Eur J Heart Fail Country: Netherlands |
Other Details:
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Languages: eng Pagination: 668-74 Citation Subset: IM |
Affiliation:
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Medical Department B, Division of Cardiology, Rigshospitalet, University Hospital of Copenhagen, Denmark. Matiasgl@dadlnet.dk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Angioplasty, Balloon, Coronary* Chi-Square Distribution Denmark / epidemiology Female Hospital Mortality Humans Incidence Male Middle Aged Myocardial Infarction / complications*, therapy* Proportional Hazards Models Registries Shock, Cardiogenic / epidemiology, etiology, prevention & control* Thrombolytic Therapy* Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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