Document Detail


Rescue angioplasty: characteristics and results in a single-center experience.
MedLine Citation:
PMID:  20807306     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE AND METHODS: Rescue angioplasty (RA) has demonstrated its efficacy for the treatment of failed thrombolysis after acute myocardial infarction (AMI). We analyzed clinical, angiographic, and procedural characteristics, and prognosis at 30 days of prospective cohort of unselected patients admitted for RA.
RESULTS: From August 2004 to August 2009, 361 patients were included in a single center. The median time pain to the thrombolysis was 140 minutes (interquartile range [IQR] 90-210), delay transfer 100 minutes (IQR 65-120); pain to PCI was 330 minutes (IQR 270-400). Initial flow TIMI 3 (Thrombolysis in Myocardial Infarction) was presented in 102 (28.3%) of cases and blush grade 3 in 88 (24.4%). After the procedure, TIMI 3 flow was achieved in 286 (79.2%) and blush grade 3 in 256 (71%) (P < 0.001 and P < 0,001, respectively). A glycoprotein IIb/IIIa receptor inhibitor (Abciximab) was used in 115 patients (32%). Stents were implanted in 339 (94%) of patients, 137 (38%) of which were drug-eluting stent. Complete ST segment resolution was observed in 202 (64.5%) patients in 12-lead electrocardiogram (ECG) and procedural success was 77.6%. Adverse cardiac events and death after 30 days follow-up were 13.6% and 10.7%, respectively. Target vessel revascularization at 30 days was 1.9%.
CONCLUSIONS: Routine application of RA in patients with persistent ST elevation 90 minutes after thrombolysis is a useful technique for achieving revascularization of the affected artery. In-hospital mortality remains high especially in patients with cardiac shock, despite new interventional techniques available, and adjunctive antithrombotic therapy.
Authors:
Patricio Pérez-Berbel; José Valencia; Juan Miguel Ruiz-Nodar; Javier Pineda; Pascual Bordes; Vicente Mainar; Francisco Sogorb
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Publication Detail:
Type:  Journal Article     Date:  2010-08-29
Journal Detail:
Title:  Journal of interventional cardiology     Volume:  24     ISSN:  1540-8183     ISO Abbreviation:  J Interv Cardiol     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-10     Completed Date:  2011-06-07     Revised Date:  2013-05-24    
Medline Journal Info:
Nlm Unique ID:  8907826     Medline TA:  J Interv Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  42-8     Citation Subset:  IM    
Copyright Information:
©2010, Wiley Periodicals, Inc.
Affiliation:
Servicio de Cardiología, Hospital General Universitario de Alicante, Spain.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Balloon*
Antibodies, Monoclonal / therapeutic use
Coronary Angiography
Drug-Eluting Stents
Female
Fibrinolytic Agents / therapeutic use
Health Status Indicators
Humans
Immunoglobulin Fab Fragments / therapeutic use
Male
Middle Aged
Myocardial Infarction / drug therapy,  therapy*
Platelet Aggregation Inhibitors / therapeutic use
Prognosis
Prospective Studies
Registries
Spain
Treatment Failure
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Fibrinolytic Agents; 0/Immunoglobulin Fab Fragments; 0/Platelet Aggregation Inhibitors; X85G7936GV/abciximab

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