Document Detail


Primary angioplasty for acute myocardial infarction.
MedLine Citation:
PMID:  9575607     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The use of thrombolytic therapy has been widely accepted for the treatment of acute myocardial infarction. Despite improving mortality, thrombolytic therapy may be contraindicated in many patients presenting with myocardial infarction and is associated with a small, yet significant risk of hemorrhagic sequelae. This article outlines the rationale behind reperfusion therapy, the use of pharmacological thrombolysis and the role of adjunctive angioplasty. The potential advantages of a therapeutic strategy of primary angioplasty, instead of thrombolysis, are discussed. These include anatomical definition, risk stratification, reduced recurrent ischemia, enhanced coronary perfusion and improved coronary patency. The randomized trials in which primary angioplasty and thrombolytic therapy were compared are reviewed. We conclude that angioplasty results in a reduction of short-term mortality and nonfatal reinfarction and therefore advocate the routine use of coronary angioplasty as a primary reperfusion strategy for acute myocardial infarction. The potential limitations of primary angioplasty in the community hospital setting are discussed. Finally, we examine the roles of adjunctive mechanical (e.g. stents) and pharmacological (e.g. Abciximab) means of further enhancing outcomes after primary angioplasty.
Authors:
C P Juergens; R J Whitbourn; A C Yeung; S N Oesterle
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Publication Detail:
Type:  Historical Article; Journal Article; Review    
Journal Detail:
Title:  Vascular medicine (London, England)     Volume:  2     ISSN:  1358-863X     ISO Abbreviation:  Vasc Med     Publication Date:  1997 Nov 
Date Detail:
Created Date:  1998-06-16     Completed Date:  1998-06-16     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9610930     Medline TA:  Vasc Med     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  327-34     Citation Subset:  IM; Q    
Affiliation:
Division of Cardiovascular Medicine, Stanford University Medical Center, CA 94305, USA.
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Transluminal, Percutaneous Coronary* / history
Combined Modality Therapy
History, 20th Century
Humans
Intra-Aortic Balloon Pumping
Myocardial Infarction / drug therapy,  therapy*
Myocardial Reperfusion
Randomized Controlled Trials as Topic
Stents
Thrombolytic Therapy*

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


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