Document Detail


Value of first day angiography/angioplasty in evolving Non-ST segment elevation myocardial infarction: an open multicenter randomized trial. The VINO Study.
MedLine Citation:
PMID:  11792138     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: Direct angioplasty is an effective treatment for ST-elevation myocardial infarction. The role of very early angioplasty in non-ST-elevation infarction is not known. Thus, a randomized study of first day angiography/angioplasty vs early conservative therapy of evolving myocardial infarction without persistent ST-elevation was conducted. METHODS: One hundred and thirty-one patients with confirmed acute myocardial infarction without ST-segment elevations were randomized within 24 h of last rest chest pain: 64 in the first day angiography/angioplasty group and 67 in the early conservative group (coronary angiography only after recurrent or stress induced myocardial ischaemia). RESULTS: All patients in the invasive group underwent coronary angiography on the day of admission (mean randomization-angiography time 6.2 h). First day angioplasty of the infarct related artery was performed in 47% of the patients and bypass surgery in 35%. In the conservative group, 55% underwent coronary angiography, 10% angioplasty and 30% bypass surgery within 6 months. The primary end-point (death/reinfarction) at 6 months occurred in 6.2% vs 22.3% (P<0.001). Six month mortality in the first day angiography/angioplasty group was 3.1% vs 13.4% in the conservative group (P<0.03). Non-fatal reinfarction occurred in 3.1% vs. 14.9% (P<0.02). CONCLUSIONS: First day coronary angiography followed by angioplasty whenever possible reduces mortality and reinfarction in evolving myocardial infarction without persistent ST-elevation, in comparison with an early conservative treatment strategy.
Authors:
R Spacek; P Widimský; Z Straka; E Jiresová; J Dvorák; R Polásek; I Karel; R Jirmár; L Lisa; T Budesínský; F Málek; P Stanka
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Evaluation Studies; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European heart journal     Volume:  23     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2002 Feb 
Date Detail:
Created Date:  2002-01-16     Completed Date:  2002-05-01     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  230-8     Citation Subset:  IM    
Copyright Information:
Copyright 2001 The European Society of Cardiology.
Affiliation:
Cardiocenter, University Hospital Královské Vinohrady, 3rd Medical School of Charles University Prague, Prague, Czech Republic.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary*
Coronary Angiography*
Coronary Artery Bypass
Electrocardiography*
Endpoint Determination
Exercise Test
Female
Follow-Up Studies
Humans
Length of Stay
Male
Middle Aged
Myocardial Infarction / mortality,  radiography*,  therapy*
Survival Analysis
Treatment Outcome
Comments/Corrections
Comment In:
Eur Heart J. 2002 Feb;23(3):191-4   [PMID:  11792131 ]

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