| Timing of and risk factors for myocardial ischemic events after percutaneous coronary intervention (IMPACT-II). Integrilin to Minimize Platelet Aggregation and Coronary Thrombosis. | |
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MedLine Citation:
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PMID: 10728945 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We studied both the time course and risk factors for adverse clinical events after percutaneous coronary intervention (PCI). Such information is critical to clinical decision-making, but scant quantitative data exist to describe the time course of these adverse outcomes. Patients enrolled in the Integrilin to Minimize Platelet Aggregation and Coronary Thrombosis-II (IMPACT-II) trial were analyzed. Patients undergoing elective, urgent, or emergency PCI (n = 4,010) were randomized to receive either placebo or 1 of 2 eptifibatide regimens during intervention. We evaluated the time to the primary end point of the trial, the 30-day composite of death, myocardial infarction, repeat nonelective PCI, nonelective bypass surgery, or stenting for abrupt closure. Adverse events occurred in 407 patients (10.1%). Because the risk of events declined substantially between 6 and 9 hours (66% occurred within 6 hours), events were classified as occurring before or after 6 hours. Independent predictors of "early" events included dissection, pre- and postprocedural coronary blood flow, side-branch occlusion, procedural thrombolytic use, previous bypass, presentation with unstable angina, absence of diabetes, and hyperlipidemia. The predictors of "late" events included lower weight, increased baseline heart rate, coronary dissection, and procedural thrombolytic use. The risk of ischemic events were greatest immediately after PCI and rapidly declined, so that by 9 hours the hazard function plot was flat; 66% of events occurred within 6 hours of PCI. Knowledge of the risk factors for early and late events help risk-stratify patients before and after intervention for myocardial ischemic events. |
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Authors:
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M C Thel; R M Califf; B E Tardiff; L H Gardner; K N Sigmon; A M Lincoff; E J Topol; M M Kitt; J C Blankenship; J E Tcheng |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: The American journal of cardiology Volume: 85 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2000 Feb |
Date Detail:
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Created Date: 2000-03-31 Completed Date: 2000-03-31 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 427-34 Citation Subset: AIM; IM |
Affiliation:
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Duke Clinical Research Institute, Durham, North Carolina 27715, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angina, Unstable / mortality, therapy* Angioplasty, Transluminal, Percutaneous Coronary / adverse effects* Coronary Thrombosis / mortality, therapy* Electrocardiography Female Humans Infusions, Intravenous Male Middle Aged Myocardial Infarction / etiology*, mortality Peptides / administration & dosage, therapeutic use Platelet Aggregation Inhibitors / administration & dosage, therapeutic use Prospective Studies Recurrence / prevention & control Risk Factors Survival Rate Thrombolytic Therapy Time Factors Treatment Outcome United States / epidemiology |
| Chemical | |
Reg. No./Substance:
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0/Peptides; 0/Platelet Aggregation Inhibitors; 0/eptifibatide |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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