Document Detail


Timing and mechanism of death determined clinically after primary angioplasty for acute myocardial infarction.
MedLine Citation:
PMID:  9202345     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We reviewed the timing and mechanism of death in 1,184 consecutive patients with acute myocardial infarction (AMI) treated with primary angioplasty from 1984 to 1995. Of 98 deaths, 48 (49%) occurred early on day 0 or 1. The mechanisms of death were pump failure in 60 patients (61%), reinfarction in 7 patients (7.1%), left ventricular rupture in 5 patients (5.1%), arrhythmia in 3 patients (3.1%), other cardiac causes in 5 patients (5.1%), stroke in 6 patients (6.1%), anoxic encephalopathy in 7 patients (7.1%), and procedure-related deaths in 5 patients (5.1%). The strongest predictors of mortality were cardiogenic shock and unsuccessful reperfusion. Our data indicate that mortality after primary angioplasty, like thrombolytic therapy, is highest in the early hours and is usually due to pump failure. In contrast to thrombolytic therapy, the incidence of death from myocardial rupture and bleeding complications is low. Future treatment strategies will need to focus on the large number of patients with early death due to pump failure, especially patients with cardiogenic shock.
Authors:
B R Brodie; T D Stuckey; C J Hansen; D B Muncy; R A Weintraub; T A Kelly; J J Berry
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  79     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1997 Jun 
Date Detail:
Created Date:  1997-07-17     Completed Date:  1997-07-17     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1586-91     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, the Moses H. Cone Memorial Hospital, and the LeBauer Cardiovascular Research Foundation, Greensboro, North Carolina, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary*
Constriction, Pathologic
Female
Hospital Mortality
Humans
Male
Middle Aged
Myocardial Infarction / mortality*,  pathology,  therapy*
Survival Analysis
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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