| Primary angioplasty reduces risk of myocardial rupture compared to thrombolysis for acute myocardial infarction. | |
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MedLine Citation:
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PMID: 9328698 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Although the mechanical complications of acute ventricular septal defect and acute mitral regurgitation are uncommon after acute myocardial infarction, these complications are associated with an extremely high morbidity and mortality. We hypothesized that the administration of thrombolytic drugs may result in hemorrhagic infarction as well as the potential for incomplete revascularization and thus may lead to an increased incidence of mechanical complications compared to primary angioplasty. Accordingly, we reviewed the data of the most contemporary thrombolytic and primary angioplasty trials and compared the incidence of mechanical complications among 36,303 patients treated with thrombolytics reported in the GUSTO trial to the incidence of mechanical complications among 1,295 patients treated with primary angioplasty obtained from the PAMI-1 and PAMI-2 trials. We found that angioplasty resulted in an overall 86% relative risk reduction in mechanical complications (2.20% vs. 0.31%, P < 0.001). In comparison to thrombolytic therapy, angioplasty resulted in an 82% decrease in acute mitral regurgitation (1.73% vs. 0.31%, P < 0.001) and a 100% decrease in acute ventricular septal defect (0.47% vs. 0.00%, P < 0.03). In conclusion, in patients with acute myocardial infarction, reperfusion with primary angioplasty is associated with less myocardial rupture and mechanical complications than thrombolytics. This finding may, in part, explain the improved prognosis observed in myocardial infarction patients treated with primary angioplasty. |
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Authors:
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J W Kinn; W W O'Neill; K H Benzuly; D E Jones; C L Grines |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Meta-Analysis; Randomized Controlled Trial |
Journal Detail:
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Title: Catheterization and cardiovascular diagnosis Volume: 42 ISSN: 0098-6569 ISO Abbreviation: Cathet Cardiovasc Diagn Publication Date: 1997 Oct |
Date Detail:
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Created Date: 1997-11-25 Completed Date: 1997-11-25 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 7508512 Medline TA: Cathet Cardiovasc Diagn Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 151-7 Citation Subset: IM |
Affiliation:
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Department of Internal Medicine, William Beaumont Hospital, Royal Oak, Michigan 48073, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Angioplasty, Transluminal, Percutaneous Coronary* Female Heart Rupture, Post-Infarction / etiology, prevention & control* Heart Septal Defects, Ventricular / etiology, prevention & control Humans Male Middle Aged Mitral Valve Insufficiency / etiology, prevention & control Myocardial Infarction / therapy* Prognosis Risk Assessment Thrombolytic Therapy* |
| Comments/Corrections | |
Comment In:
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Cathet Cardiovasc Diagn. 1997 Oct;42(2):157
[PMID:
9328699
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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