| Results of primary angioplasty for acute myocardial infarction in patients with multivessel coronary artery disease. | |
MedLine Citation:
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PMID: 2229753 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The influence of multivessel coronary artery disease on the outcome of reperfusion therapy for myocardial infarction has not been fully characterized. Direct coronary angioplasty without antecedent thrombolytic therapy was performed during evolving myocardial infarction in 285 patients with multivessel coronary artery disease at 5.2 +/- 4.2 h after the onset of chest pain. Two vessel disease was present in 163 patients (57%) and three vessel disease in 122 (43%). An anterior infarct was present in 123 patients (43%), cardiogenic shock in 33 (12%) and age greater than or equal to 70 years in 59 (21%). Angioplasty of the infarct-related vessel was successful in 256 patients (90%), including 92% with two vessel and 88% with three vessel disease (p = NS). Emergency bypass surgery was needed in six patients (2%). In-hospital death occurred in 33 patients (12%), including 13 with two vessel and 20 with three vessel disease (p less than 0.05). The mortality rate was only 4% in the subgroup of 101 patients who met entry criteria for thrombolytic trials. The in-hospital mortality rate was 45% in patients in shock and 7% in patients not in shock (p less than 0.01). Logistic regression analysis identified shock and age greater than or equal to 70 years as independently associated with in-hospital death. In 135 patients who underwent predischarge left ventriculography, global ejection fraction increased from 50% to 57% (p less than 0.001) and regional wall motion in the infarct zone improved in 59% of patients. Follow-up data were available in 251 patients (99%) at a mean of 35 +/- 19 months.(ABSTRACT TRUNCATED AT 250 WORDS) |
Authors:
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J K Kahn; B D Rutherford; D R McConahay; W L Johnson; L V Giorgi; T M Shimshak; R Ligon; G O Hartzler |
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Publication Detail:
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Type: Clinical Trial; Journal Article |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 16 ISSN: 0735-1097 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 1990 Nov |
Date Detail:
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Created Date: 1990-12-11 Completed Date: 1990-12-11 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1089-96 Citation Subset: AIM; IM |
Affiliation:
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Cardiovascular Consultants, Inc., Mid America Heart Institute, St. Luke's Hospital, Kansas City, Missouri 64111. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Angioplasty, Transluminal, Percutaneous Coronary* Coronary Artery Bypass Coronary Disease / mortality, therapy* Coronary Vessels / pathology Emergencies Female Humans Male Middle Aged Myocardial Infarction / mortality, therapy* Myocardial Reperfusion / methods Regression Analysis Survival Analysis |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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