| Value of first day angiography/angioplasty in evolving Non-ST segment elevation myocardial infarction: an open multicenter randomized trial. The VINO Study. | |
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MedLine Citation:
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PMID: 11792138 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Clinical Trial; Comparative Study; Evaluation Studies; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: European heart journal Volume: 23 ISSN: 0195-668X ISO Abbreviation: Eur. Heart J. Publication Date: 2002 Feb |
Date Detail:
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Created Date: 2002-01-16 Completed Date: 2002-05-01 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8006263 Medline TA: Eur Heart J Country: England |
Other Details:
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Languages: eng Pagination: 230-8 Citation Subset: IM |
Copyright Information:
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Copyright 2001 The European Society of Cardiology. |
Affiliation:
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Cardiocenter, University Hospital Královské Vinohrady, 3rd Medical School of Charles University Prague, Prague, Czech Republic. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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Eur Heart J. 2002 Feb;23(3):191-4
[PMID:
11792131
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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