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Titolo:
Primary angioplasty versus systemic thrombolysis in anterior myocardial infarction
Autore:
Garcia, E; Elizaga, J; Perez-Castellano, N; Serrano, JA; Soriano, J; Abeytua, M; Botas, J; Rubio, R; de Sa, EL; Lopez-Sendon, JL; Delcan, JL;
Titolo Testata:
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
fascicolo: 3, volume: 33, anno: 1999,
pagine: 605 - 611
SICI:
0735-1097(19990301)33:3<605:PAVSTI>2.0.ZU;2-4
Fonte:
ISI
Lingua:
ENG
Soggetto:
PRIMARY CORONARY ANGIOPLASTY; INTRAVENOUS STREPTOKINASE; PROGNOSTIC-SIGNIFICANCE; IMMEDIATE ANGIOPLASTY; THERAPY; LOCATION; REINFARCTION; ALTEPLASE; MORTALITY; TRIALS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
30
Recensione:
Indirizzi per estratti:
Citazione:
E. Garcia et al., "Primary angioplasty versus systemic thrombolysis in anterior myocardial infarction", J AM COL C, 33(3), 1999, pp. 605-611

Abstract

OBIECTIVES This study compares the efficacy of primary angioplasty and systemic thrombolysis with t-PA in reducing the in-hospital mortality of patients with anterior AMI. BACKGROUND Controversy still exists about the relative benefit of primary angioplasty over thrombolysis as treatment for AMI. METHODS Two-hundred and twenty patients with anterior AMI were randomly assigned in our institution to primary angioplasty (109 patients) or systemicthrombolysis with accelerated t-PA (111 patients) within the first five hours from the onset of symptoms. RESULTS Baseline characteristics were similar in both groups. Primary angioplasty was independently associated with a lower in-hospital mortality (2.8% vs. 10.8%, p = 0.02, adjusted odds ratio 0.23, 95% confidence interval 0.06 to 0.85). During hospitalization, patients treated by angioplasty had alower frequency of postinfarction angina or positive stress test (11.9% vs. 25.2%, p = 0.01) and less frequently underwent percutaneous or surgical revascularization after the initial. treatment (22.0% vs. 47.7%, p < 0.001) than did patients treated by t-PA. At six month follow-up, patients treatedby angioplasty had a lower cumulative rate of death (4.6% vs. 11.7%, p = 0.05) and revascularization (31.2% vs. 55.9%, p < 0.001) than those treated by t-PA. CONCLUSIONS In centers with an experienced and readily available interventional team, primary angioplasty is superior to t-PA for the treatment of anterior AMI. (C) 1999 by the American College of Cardiology.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 02/04/20 alle ore 06:20:35