| Safety of single versus multi-vessel angioplasty for patients with acute myocardial infarction and multi-vessel coronary artery disease: report from the New York State Angioplasty Registry. | |
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MedLine Citation:
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PMID: 16374145 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The conventional strategy for primary angioplasty during acute myocardial infarction is angioplasty of the infarct-related vessel, even in patients with multi-vessel disease. Patients, however, often have significant lesions in multiple coronary arteries and a strategy for multi-vessel angioplasty during acute myocardial infarction has not been explored. The purpose of this study was to examine whether multi-vessel angioplasty is as safe as infarct-related vessel angioplasty in patients with multi-vessel coronary artery disease during acute myocardial infarction. METHODS: Using the 2000-2001 New York State Angioplasty Registry database, we compared the in-hospital clinical outcomes of patients with multi-vessel disease (>70% stenosis in at least two major coronary arteries), who underwent either multi-vessel angioplasty (n=632) or infarct-related vessel angioplasty (n=1350) within 24 h of acute myocardial infarction. Patients with previous myocardial infarction, angioplasty, bypass surgery, or cardiogenic shock were excluded. RESULTS: Patients in the multi-vessel angioplasty group were less likely to be female, to have peripheral vascular disease or diabetes. They had more complex lesions and were more likely to receive stents. In-hospital mortality was three-fold lower (0.8 versus 2.3%, P=0.018) in the multi-vessel angioplasty group. No differences were observed in other ischemic complications, renal failure, or length of stay. After multivariate analysis, multi-vessel angioplasty remained a significant predictor of lower in-hospital death (odds ratio=0.27, 95% confidence interval=0.08-0.90, P=0.03). CONCLUSIONS: Despite the added complexity of multi-vessel angioplasty, patients in this group had significantly lower in-hospital mortality. Therefore, a strategy of multi-vessel angioplasty during acute myocardial infarction may be safe compared with infarct-related angioplasty in selected patients. |
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Authors:
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James A Kong; Eric T Chou; Robert M Minutello; Shing Chiu Wong; Mun K Hong |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Coronary artery disease Volume: 17 ISSN: 0954-6928 ISO Abbreviation: Coron. Artery Dis. Publication Date: 2006 Feb |
Date Detail:
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Created Date: 2005-12-23 Completed Date: 2006-05-16 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9011445 Medline TA: Coron Artery Dis Country: England |
Other Details:
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Languages: eng Pagination: 71-5 Citation Subset: IM |
Affiliation:
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New York Presbyterian Hospital-Weill Cornell Campus, New York, New York 10021, USA. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Angioplasty, Transluminal, Percutaneous Coronary
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methods* Coronary Angiography Coronary Disease / mortality, radiography, therapy* Female Follow-Up Studies Humans Male Middle Aged Myocardial Infarction / mortality, radiography, therapy* New York / epidemiology Retrospective Studies Severity of Illness Index Survival Rate Treatment Outcome |
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