Document Detail


Percutaneous reperfusion of left main coronary disease complicated by acute myocardial infarction.
MedLine Citation:
PMID:  11979530     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Previous studies have shown a benefit of a strategy of direct angioplasty and stenting in patients with acute myocardial infarction (AMI) complicated by early cardiogenic shock. However, few data exist for the subset of patients with left main trunk disease complicated by AMI and cardiogenic shock. We performed an analysis of patients with AMI who underwent mechanical intervention between January 1995 and December 2000. Out of 1,433 patients with ST segment elevation AMI treated with primary coronary angioplasty (PTCA), 22 patients (1.5%) had left main disease (LMD) as the culprit lesion. Baseline characteristics were age, 66 +/- 11 years; female gender, 9%; diabetes, 14%; previous myocardial infarction, 14%; mean systolic blood pressure, 77 +/- 24 mm Hg; time to treatment, 4.8 +/- 2.2 hr; TIMI 0-1, 77%; collateral flow (Rentrop grade >or= 2) 9%. The primary success rate was 91%. Primary stenting was performed in 17 patients (77%). The in-hospital mortality rate was 50%. All deaths were due to refractory shock. The 6-month survival rate was 41% +/- 1%, while the event-free survival rate was 27% +/- 10%. At 6-month follow-up, the mortality rate increased to 59%; the target vessel revascularization rate was 14%. A percutaneous mechanical intervention strategy in patients with left main disease complicated by AMI is feasible and effective, and patients discharged alive have a good mid-term prognosis.
Authors:
Roberto Neri; Angela Migliorini; Guia Moschi; Renato Valenti; Emilio Vincenzo Dovellini; David Antoniucci
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  56     ISSN:  1522-1946     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2002 May 
Date Detail:
Created Date:  2002-05-23     Completed Date:  2002-06-28     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  31-4     Citation Subset:  IM    
Copyright Information:
Copyright 2002 Wiley-Liss, Inc.
Affiliation:
Division of Cardiology, Careggi Hospital, Florence, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angioplasty, Transluminal, Percutaneous Coronary
Arteries / surgery
Blood Vessel Prosthesis Implantation
Coronary Angiography
Coronary Disease / complications*,  mortality,  therapy*
Coronary Vessels / surgery
Female
Follow-Up Studies
Hospital Mortality
Humans
Male
Middle Aged
Myocardial Infarction / complications*,  mortality,  therapy*
Myocardial Reperfusion*
Postoperative Complications / etiology,  mortality
Recurrence
Reoperation
Stents
Treatment Outcome

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


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