Document Detail

Primary coronary angioplasty in ST-elevation myocardial infarction: prediction of the thirty-day mortality risk in an unselected population of patients.
MedLine Citation:
PMID:  15320568     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The 30-day mortality in catheter-based reperfusion therapy in patients with acute myocardial infarction varies widely in the literature and only some factors, such as cardiogenic shock, are clearly associated with the risk. This non-randomized, single center study investigates the potential factors influencing the 30-day mortality in 586 consecutive patients with ST-elevation myocardial infarction, treated with primary coronary angioplasty (PTCA). METHODS: In the whole series and in two subgroups (with and without cardiogenic shock) the clinical, angiographic and procedural variables were used to develop multivariate statistical models for the prediction of the endpoint. RESULTS: The overall 30-day mortality was 7.3%: 35.8 and 4.5% in patients with and without cardiogenic shock, respectively (p < 0.001). Independent predictors of the 30-day mortality included: a) in the entire series: shock, PTCA angiographic success, time to treatment, age, and coronary artery disease extension; b) in patients with cardiogenic shock: PTCA angiographic success, time to treatment, coronary artery disease extension, and use of abciximab; c) in patients without cardiogenic shock: time to treatment, age, and coronary artery disease extension. CONCLUSIONS: In patients with ST-elevation myocardial infarction submitted to primary PTCA, the 30-day mortality rate is a highly predictable endpoint. The role of abciximab therapy and of other independent predictors varies according to the presence or otherwise of cardiogenic shock.
Antonio Parma; Rosario Fiorilli; Marco Stefano Nazzaro; Maurizio Menichelli; Edoardo Pucci; Francesco De Felice; Carla Boschetti; Paolo Salvini; Roberto Violini
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Italian heart journal : official journal of the Italian Federation of Cardiology     Volume:  5     ISSN:  1129-471X     ISO Abbreviation:  Ital Heart J     Publication Date:  2004 Jun 
Date Detail:
Created Date:  2004-08-23     Completed Date:  2004-11-02     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  100909716     Medline TA:  Ital Heart J     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  431-40     Citation Subset:  IM    
Interventional Cardiology Unit, Department of Cardiac Sciences, San Camillo-Forlanini Hospital, Rome, Italy.
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MeSH Terms
Aged, 80 and over
Angioplasty, Transluminal, Percutaneous Coronary*
Chi-Square Distribution
Logistic Models
Middle Aged
Myocardial Infarction / mortality*,  therapy*
Predictive Value of Tests
Statistics, Nonparametric
Survival Analysis
Time Factors
Treatment Outcome

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